What Exactly Is Adrenal Fatigue?

With the ongoing pandemic, political and social challenges, potential financial instability and work/life issues, feeling depleted and sapped of energy, unfortunately, seems to be the new normal.

Turning to self-care basics like getting enough quality sleep, eating healthy meals and exercising regularly can usually provide significant changes in energy levels. But if you’re trying all of those and still feeling wiped out, you may be dealing with adrenal fatigue.

“Although not fully accepted as a true diagnosis by some doctors, adrenal fatigue can feel very real if you have it,” says Dr. Luiza Petre, assistant clinical professor of cardiology at the Mount Sinai School of Medicine. “It is a mild form of adrenal insufficiency, and can often lead to fibromyalgia.”

Despite not being recognized as an official diagnosis, adrenal fatigue can cause symptoms among those who struggle with the issue. A chronic “always-on” stress reaction can lead to higher cortisol levels. The hormone is responsible for your fight-or-flight response and can cause sleep disruptions, irritability, frustration, anxiety and feeling overwhelmed.

When that continues, it can “burn out” your adrenal system — which is responsible for regulating your metabolism, immune system, blood pressure and stress response — causing your cortisol level to drop. Although that sounds like a good thing, we need a certain amount of the hormone to function properly and maintain energy. With the adrenal system not regulating these hormones efficiently, you’ll lack the resilience to deal with stress, and yet still have those stressors.

“This can cause stress to keep increasing, even when you feel like you’ve reached your limit,” says Petre. “That’s when physical symptoms become even more pronounced.”

The most common symptom is a feeling of deep, extensive, continuous exhaustion. That can be physical in the form of fatigue and mental — you may feel like you just can’t drum up the energy to care about what used to fire you up.

Keep in mind that also describes depression, so it’s worth getting screened if you’re feeling this way. While current events are enough to make anyone feel depleted, you should find some relief if you take a break from the news and employ some self-care strategies for a day or two. If you’re not getting that relief, there may be more extensive issues like adrenal fatigue, depression or fibromyalgia at play.

One of the symptoms of adrenal gland disorders is muscle and bone weakness, mainly because chronically elevated cortisol levels can cause more breakdown of your body’s proteins, leading to loss of muscle mass and bone density. When that happens, it can lead to feeling achy in a non-specific way.

This can be very frustrating, says Petre, because it can “move around” from day-to-day. You might feel back pain one day, then neck pain the next, and an all-over ache and headache after that, followed by no pain at all for a day. That’s part of why people who struggle with the issue feel reluctant to talk with a doctor about it, or why some doctors question whether it’s a psychosomatic reaction to stress and believe the pain may not be “real.”

Related to the sense of deep exhaustion adrenal issues can bring, you might find yourself veering away from healthy food choices and toward sugary foods and caffeinated beverages since they provide very brief energy boosts.

But these choices usually make the issue worse, since they can cause blood sugar crashes that leave you feeling even more tired than before. If that limits your physical activity, the cycle of sugar, caffeine and sedentary behavior can get ugly. And it can exacerbate physical symptoms like body aches and headaches.

One of the most significant ways to ease adrenal fatigue symptoms may also be the toughest, according to Petre: regular workouts.

“In the setting of this neuro-muscular fatigue, it’s harder to get involved in sustained and intense exercise,” she says. “Despite that, exercise itself can be the best thing one can implement from a lifestyle change perspective to help with symptoms.”

If you’re not ready to dial up the intensity yet, start with taking 15-minute walks outside in the fresh air, at a slightly quicker pace than you usually have, suggests Petre. This can help stress relief and get you on track toward incorporating more exercise into your routine.

Continuing with healthy lifestyle choices like eating nutritious food, maintaining social connection, finding ways to de-stress and focusing on quality sleep can help, but be cautious with that last one, says Dr. W. Christopher Winter, president of Charlottesville Neurology and Sleep Medicine and author of “The Sleep Solution.”

“When you’re feeling depleted and fatigued for any reason, the temptation is to rest and sleep more, including sleeping in and taking long naps,” he says. “Unfortunately, that can make your issues worse because you’ll be throwing off your body clock. It’s better to create more bedtime routines and a firm sleep schedule, especially if you’re finding that naps or longer-duration sleep isn’t helping.”

Even if your doctor doesn’t accept adrenal fatigue as an official diagnosis, the fact is, if you’re struggling, and if nothing is helping, it’s worth getting checked and having some bloodwork done. Petre says what may seem like adrenal fatigue could be something else, like a thyroid issue or other hormone problem.

You could also be dealing with fibromyalgia, a disorder that also comes with extensive musculoskeletal pain, fatigue, sleep problems and mood shifts. Also once dismissed as a psychological issue instead of an actual disorder, fibromyalgia now has treatment options that include medication, physical therapy and pain management.

If you feel like you’re suffering from either adrenal fatigue or fibromyalgia, you may need a referral to a rheumatologist for appropriate screening and treatment.

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