Ep. #1008: The Truth About Adrenal Fatigue
Hey, there I am Mr. Mike Matthews, and this is Muscle for Life. Thank you for joining. For a new episode on a controversial condition, adrenal fatigue. Now this term, this was coined in the early two thousands by a chiropractor and naturopathic doctor named James Wilson to describe a syndrome that people supposedly suffer from in response to prolong.
Stress. So according to Wilson, when you live with long-term stress, this puts undue strain on your adrenal glands, which sit on top of your kidneys and secrete hormones such as cortisol and adrenaline. Now, over time, the theory goes. This strain fatigues your adrenals and can even stop them from functioning correctly, and that then can cause your body to feel lethargic and can negatively impact your health and body composition in various ways.
And it sounds like a plausible theory, but as I mentioned just a few minutes ago, it is highly controversial in the medical world primarily. Because there is no explicit scientific evidence that it exists. And so in this podcast, I am going to look at the broader body of research on adrenal function and fatigue, and let’s see what we can learn about this theory of adrenal fatigue and whether it is worthy of merit or mockery, but, If you like what I’m doing here on the podcast and elsewhere, then you will probably like my award-winning fitness books for men and women of all ages and abilities, which have sold over 2 million copies, have received over 15,004 and five star reviews on Amazon, and which have helped tens of thousands of people build their best body.
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And if you are a guy or gal, 40 to maybe 45 plus muscle for life is for you. Okay, so what is adrenal fatigue or adrenal fatigue syndrome as it is sometimes called? Well, it is a set of symptoms that purportedly occur in people under long-term, mental, physical, or emotional stress. Now medical doctors do not classify adrenal fatigue as a true medical condition, and therefore the only way that you can receive a diagnosis is from a holistic or a functional health practitioner.
And the theory behind. Adrenal fatigue is based on Hans Cellier general adaptation syndrome, which describes three phases that your body goes through in response to long-term stress. And so here’s how health practitioners typically characterize each stage. In the context of adrenal fatigue, so in the first phase, you have what is sometimes called the alarm reaction response.
And this occurs in response to a stressful situation. And this can last days or even weeks. And during this period, your adrenal glands release cortisol, which is the body’s main stress hormone and adrenaline, which triggers your body’s fight or. Response. And if the source of stress persists, you then progress to phase two.
And phase two is sometimes called the resistance response phase, and this is where the theory goes. Your adrenal glands begin to fatigue as they struggle to keep up with your body’s demand for more and more cortisol. This then causes cortis. Levels to dip, which then brings about several adverse side effects.
And if you fail to control your stress levels, if you fail to lower your stress levels and allow phase two to continue for too long, you enter phase three. And this is often referred to as the adrenal exhaustion phase. And in this phase, Your adrenal glands become exhausted. Cortisol levels fall further, and according to people who believe in this theory, it’s in this third phase that your body basically goes haywire.
Hormones get all screwed up. You become insufficient or even deficient in certain vitamins and minerals and other nutrients, and your metabolism starts to become dysfunctional. And those things can then cause many other health problems. Now, many people who wonder if they have adrenal fatigue to one degree or another, can find lists of symptoms online for each of these phases that supposedly indicate the likelihood that you are experiencing adrenal.
Fatigue. So for example, usually phase one has few symptoms, at least few noticeable symptoms, although sometimes it’s claimed that you might have high blood pressure and an elevated heart rate in phase one. And then in phase two it is often reported that people feel more fatigued than usual at the end of the day, and they feel less.
Rested in the morning, even if they have slept enough. Anxiety is usually on the list here. Irritability, sluggishness, sometimes weight gain or difficulty maintaining body weight with no noticeable changes, at least no changes they’re aware of to their diet and exercise routine. And then in phase three, the symptoms become more and more serious.
So often you will see people talk about encountering more issues with allergies and asthma, compromised immune function, autoimmune disease, gastrointestinal distress, food intolerances, infertility, low sex drive, depression, weight gain, muscle loss, joint pain, brain fog, apathy, lightheaded. Cravings for salt and sugar, osteoporosis, skin conditions and insomnia, rather long list.
And to make matters even worse, many proponents of adrenal fatigue will say that if you remain in phase three for too long, you eventually reach a complete burnout, a wipe out. And if that happens, your risk of cardiovascular disease and. Death apparently skyrockets. Alright, so that’s the theory of adrenal fatigue and the symptoms usually used to diagnose it.
The big question though, is it real? Is it really a medical condition that can be properly diagnosed and. Treated well despite what many alternative health practitioners say, there is very little scientific evidence that adrenal fatigue exists. For example, one of the central tenets of the theory underlying adrenal fatigue is that chronic, so long-term stress frazzles your adrenal glands, and that then causes your cortisol levels to bottom out, and that triggers a raft of undesirable and potentially life threaten.
Symptoms. However, multiple studies show that people suffering from chronic work-related stress tend to have higher cortisol levels than healthy people in the morning, not lower. And that both groups have similar cortisol levels throughout the remainder of the day. And it’s a similar story if you look into research conducted with high level athletes following very rigorous training.
Routines. For example, in one meta-analysis, researchers found that in most cases, overtrained and healthy athletes have similar cortisol levels, and both groups levels are within a healthy range. And keep in mind that in the scientific literature, over training is an extreme condition. It is not possible to overtrain if we’re talking about the scientific term.
Over train by lifting weights, let’s say four to six hours per week and doing a couple of hours of cardio. It takes a ton of exercise, and it also usually takes extreme dietary restriction, particularly energy restriction, calorie restriction. As well. So again, in research with truly overtrained athletes, athletes who have ground themselves down over a long period of time, they show similar cortisol levels to healthy athletes and their cortisol levels.
The overtrained athletes are still within a healthy range. Research also shows that people suffering from. Pain or illness such as metabolic syndrome, heart disease, depression, Hashimotos, that’s hypothyroidism, schizophrenia, bipolar disorder, fibromyalgia. In all of those conditions, people typically have higher or similar cortisol levels compared to healthy people, not lower, and that’s despite dealing with a lot more stress, physical.
Mental studies that investigated the link between cortisol and chronic fatigue offer Interesting insight to this conversation as well. If cortisol levels and fatigue were linked as adrenal fatigue, advocates suggest, you’d expect to see clear trends of that in the scientific literature. Specifically, you would expect most, if not all, participants in chronic fatigue studies to have.
Cortisol levels. You’d also expect to find a reliable relationship between their cortisol levels and the severity of their fatigue of their symptoms so that those with the worst symptoms would also have the lowest cortisol levels. That is not the case though. Most research shows that chronically fatigued people have similar or higher cortisol levels compared to healthy people.
Now, there are some studies that have shown that fatigued. Can have lower cortisol levels, but those tend to be the exception rather than the rule. And remember, when you are looking at scientific evidence, you have to look at the totality of the available evidence of the high quality evidence, the weight of the evidence, and most of that high quality research shows, again, similar or higher cortisol levels.
In the case of chronic fatigue, not. Another strike against the adrenal fatigue construct, I guess you could say, is there does not appear to be a reliable relationship between cortisol levels and the severity of the fatigue symptoms, nor is it always the case that symptoms improve as cortisol rises. So as you can see, this hypothesis that is underpinning adrenal fatigue is failing the very simple scientific test of prediction.
Does it predict things that we can go observe? No, it does not. In fact, it is predicting things that are the opposite of what. Observe, and if that were not enough to convince you that adrenal fatigue is probably not a legitimate medical condition, this one should be the clincher. Despite their best efforts, scientists cannot find any evidence that adrenal.
Fatigue exists or any link whatsoever between dysfunctional adrenal glands and fatigue. For example, in a meta-analysis conducted by scientists at the Federal University of Sao Paolo, researchers reviewed 58 different studies to see if there was. Any association, any evidence for a relationship between adrenal impairment and fatigue.
And when they scrutinized the data, what they discovered is that shoddy assessment techniques, unsubstantiated methodologies, false premises, incoherent research directions, and inappropriate and invalid conclusions permeated most of the literature. What’s more? They found no consistency in the results. In other words, the best research that you can find that you can draw on to support the adrenal fatigue hypothesis was ineptly conducted illogical and contradictory.
And so the researchers concluded that adrenal fatigue is a myth and the US endocrine society seconds that as. So unless circumstances drastically change somehow, unless there is high quality research to support at least some aspect of the underlying theory, my position currently is there is no evidence, direct or otherwise that your adrenal.
Glands fatigue over time and that that causes adrenal fatigue. There’s also no reason to believe that chronic stress bottoms out your cortisol levels and that that then creates the symptoms that are generally associated with adrenal. Fatigue. So in short, I think it’s fair to conclude that adrenal fatigue, as many people understand it, and as it is explained, mechanistically does not exist.
That said, there are people who suffer from symptoms that are associated with adrenal fatigue, with each of those three phases that I mentioned earlier, and those symptoms can. Very real. So I don’t want to suggest that people who say they are suffering from those symptoms are making it up or that it’s merely psychosomatic or something like that.
But my best recommendation to people who are experiencing those types of symptoms is to first assess your lifestyle. Are you exercising regularly? Are you doing some strength training as well as some cardiovascular training? Are you getting plenty of sleep, consistently getting enough sleep, at least seven, if not eight plus hours per night?
And if you are not able to get enough sleep consistently at night, are you supplementing with naps? Are you following a good diet? Are you eating a lot of relatively unprocessed, highly nutritious foods? And are you managing your stress levels well? Are you ensuring that you are not letting yourself get overstrung?
You don’t have to try to minimize stress necessarily, but no matter how gritty we are, we can only take so much. And remember that there’s physical stress that we experience in our workouts, for example, but there’s also psychological and emotional stress that just comes with being human. All three of those forms of stress impact the physiology of our body, and we can only take so much before the wheels start to fall off.
And so you just need to know yourself and know your body and how much you and your body can take, and how much is too much, and try not to red. Yourself too often now, if you are doing all of those things consistently and still experiencing some of the more serious side effects generally associated with adrenal fatigue.
Some of the phase three stuff that I mentioned earlier, like compromised immune function, which means you get sick fairly often and gastrointestinal distress, your stomach is always upset. Food intolerances, very sensitive stomach, low sex drive, depression. Low energy levels, weight gain and so forth.
Please go see your doctor, explain to them what’s going on, and if they are skilled at what they do, they probably will have you get some blood work done so you can start digging into what is really. Happening because the problem is not your adrenal glands. Your adrenal glands are almost certainly fine.
It is something else. And very often getting blood work done with a competent medical practitioner can help find out what that something else is. Well, I hope you liked this episode. I hope you found it helpful, and if you did subscribe to the show because it makes sure that you don’t miss new episodes.
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Shoot me an email, mike muscle for life.com, muscle f o r life.com and let me know what I could do better or just, uh, what your thoughts are about maybe what you’d like to see me do in the future. I read everything myself. I’m always looking for new ideas and constructive feedback. So thanks again for listening to this episode, and I hope to hear from you.