I can’t tell you how many messages I still receive on a regular basis from people asking me “if I was aware that Adrenal Fatigue is not real.” My answer is always the same: Just because it does not have a medical diagnosis, doesn’t mean it’s not real. Adrenal Fatigue is the “umbrella term” that functional medicine practitioners use to describe the symptoms patient’s experience when there is HPA-Axis Dysfunction (more on that in a second).

Diagnosing the Root Cause

The truth is, I medically diagnose the exact issue.  For example, a patient who presents to my clinic with salt cravings, afternoon fatigue and the consistent inability to “not be able to get going in the morning,” I lean towards “under-active adrenal glands.”  Upon confirmation through functional lab testing, that patient will receive a diagnosis of “E27.40 – Adrenal Gland Insufficiency.” (This is not to be confused with Addison’s Disease, which is late-end stage adrenal insufficiency and a very serious condition.)

What is the HPA-axis?

The HPA-axis is a network of communication, “signals” that exist between the hypothalamus, the pituitary gland and the adrenal glands. This network is responsible for how we respond to stress and we therefore, can not survive without it.  When neurotransmitters from your brain (hypothalamus) don’t communicate well with your endocrine system (pituitary gland and adrenal glands), due to chronic stress, illness, etc., your adrenal glands can begin to over-produce or under-produce the hormones we rely on daily.  If left unaddressed, the adrenal glands become “fatigued,” and boy – do we feel it! Therein lies how functional practitioners coined the term, “Adrenal Fatigue Syndrome.”

The signals of the HPA-axis are utilized by virtually every cell and physiological system of the body to optimize performance according to circadian, environmental and physiological demands. Disturbances in normal HPA-axis activity are associated with a wide variety of physiological and mental health disorders. (1)

The Stress Response

Simply put, it all beigns with a “stressor.”  It could be anything from a moment of actual physical danger (like running from a tiger), to the nervous joy about an upcoming wedding, all the way over to worry about a job interview.  What happens next is complex but pretty neat (if you ask me):

  1. Your brain (hypothalamus) releases a neurotransmitter to signal the endocrine system (pituitary gland) that it’s “Go-Time”
  2. Next, the endocrine system begins it’s role in your stress response by the pituitary gland releasing a neuromodulator to signal the adrenals glands to produce cortisol and release adrenaline (epinephrine)
  3. Cortisol raises blood sugar
  4. Adrenaline raises your heart rate and increases your blood pressure

When Cortisol Takes Over

In the case of adrenal fatigue, the body is in a constant state of fight or flight, and the adrenals are continuously pumping cortisol into your bloodstream. The abundance of cortisol alters leads to hormonal imbalances and a depressed immune response.  Ever have a co-worker or friend that is stressed out all the time? And always sick? Perhaps we can find some new compassion for this person now, because this is the exact mechanism as to why they are stuck in that pattern.  The increased of risk of many health problems due to cortisol-in-control includes but is not limited to:

  • Anxiety
  • Depression
  • Digestive problems
  • Headaches
  • Heart disease
  • Sleep problems
  • Memory and concentration impairment (2)


Final Thoughts

The stress of life is inevitable, but there are so many free resources available to us now to cope with stress and put a proper, realistic system of management in place.  If you find yourself experiencing any of the symptoms associated with H.P.A Axis Dysfunction and/or Adrenal Fatigue, maybe it is time to explore what functional medicine can do for you and your overall health.