LOOKING FOR AN REBOOT?
Are you constantly feeling exhausted but struggle to sleep well? Are you unable to lose your baby weight because you’re always craving high fat foods, carbs and sugar? Do you feel depleted often? Are your stresses long-term and intense? Do you experience an “afternoon slump”? Congratulations, you must be a new parent!
No, seriously. The questions above are based on a questionnaire in naturopath and chiropractor James Wilson’s 1998 book Adrenal Fatigue, and answering “yes” to enough of them apparently puts you in line for this fancy new disorder.
The idea that your adrenal glands can “tire out” from overuse has become a popular one. Let’s investigate...
LET’S START WITH A LITTLE LESSON IN HUMAN ANATOMY
Your adrenal glands are small glands that sit on top of the kidneys. They communicate with the brain to produce several hormones, including the stress hormone cortisol, epinephrine (adrenaline) and norepinephrine. The stress hormones are active in the “fight or flight” response humans and other animals have when encountering danger (or, in our modern lives, stress). “You need cortisol during periods of biological stress, not necessarily psychological stress,” explains Prof David Segal, a specialist paediatric endocrinologist based at the University of the Witwatersrand and the Donald Gordon Hospital. “Cortisol controls your blood sugar and blood pressure levels. Under stress it makes your adrenaline and noradrenaline work better, so that you can react appropriately.” For instance, if you were approaching a road hazard and your pupils did not dilate, your heart rate did not increase, your reactions did not speed up, you might not be able to act fast enough to avoid the accident.
Recently the idea has developed that people under constant longterm stress, such as workaholics or alcoholics or drug addicts or even single parents, are people who have pushed their adrenal glands to the very brink of destruction. “According to the theory of adrenal fatigue,” says the US Endocrine Society on its public-education website hormone.org, “when people are faced with longterm stress, their adrenal glands cannot keep up with the body’s need for these hormones. When this happens, symptoms of ‘adrenal fatigue’ may appear.”
BUT IT’S NOT THERE
The problem is there is no evidence that this is how the human body works. Scientists can find no evidence that your body stops producing the cortisol and other hormones and chemicals it must produce when you are under stress.
The symptoms Wilson listed in his questionnaire are, as the Endocrine Society says, “common and non-specific, meaning they can be found in many diseases. They also can occur as part of a normal, busy life. “’Adrenal fatigue’ is not a real medical condition,” the Society continues. “There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms.” Genuine adrenal insufficiency is a medical condition with symptoms that are an “order of magnitude worse than so-called adrenal fatigue,” says Prof Segal.
“Adrenal insufficiency is a real medical condition that occurs when our adrenal glands cannot produce enough hormones. Adrenal insufficiency is caused by damage to the adrenal glands or a problem with the pituitary gland—a peasized gland in the brain that tells the adrenals to produce cortisol,” writes the Endocrine Society. Symptoms include weight loss, dehydration, dizziness, low blood pressure, confusion, nausea, vomiting, diarrhoea and stomach ache.
“Adrenal insufficiency is diagnosed by means of complex laboratory investigations and protocols,” says Prof Segal. “Importantly, when you give these people cortisol replacement medication their symptoms disappear.”
“Testing should only be performed after a consult with an endocrinologist or physician familiar with how these tests are performed and why. Do not try to selfdiagnose adrenal insufficiency. Random testing of cortisol levels, salivary cortisol levels or urine collections are useless,” cautions Prof Segal.