“Adrenal Fatigue” + Why It Happens

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I'm Dr. Mamie!

I'm trained in naturopathic medicine + Chinese medicine + functional medicine, and I teach women how to transform their health using natural therapies + a root-cause approach! I share the truth as I know it.

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What are the Adrenals?

Your adrenals are little hat-shaped glands that sit on top of each kidney. They’re called to action when you experience mental, emotional, or physical stress, and they respond by secreting cortisol and other stress hormones.

But your adrenal glands play other roles besides responding to stress. This includes maintaining water and electrolyte balance, controlling blood pressure, regulating metabolism, and impacting the immune system and inflammation. 

The far-reaching impact of adrenal function means you can experience a variety of symptoms if your adrenals aren’t balanced and happy.

And because chronic stress leads to adrenal dysfunction, this also helps to explain why stress can cause and worsen SO MANY symptoms and conditions.

“Adrenal Fatigue”

You may have heard the term “adrenal fatigue” in recent years. This is a popular way of labeling adrenal dysfunction, but it’s actually misleading and inaccurate.

Because your adrenals don’t fatigue.

We see proof of this in patients suffering from Cushing’s, where an autoimmune response is causing increased production of cortisol by the adrenal glands. 

In these patients, the adrenal glands do NOT stop producing cortisol without medical intervention, no matter how long this disease process is allowed to continue. This is because the adrenal glands don’t fatigue. It’s not how they are designed to work.

So what people are really describing when the phrase “adrenal fatigue” is used is hypothalamic-pituitary-adrenal axis dysfunction, or HPA axis dysregulation.  

I know—it’s a mouthful! So I usually refer to this as adrenal dysfunction.

With HPA axis dysregulation (adrenal dysfunction), what’s really happening is the communication between the brain and the adrenal glands has become dysfunctional due to ongoing or significant stressors. 

This miscommunication creates imbalances in how the adrenal glands are functioning, which can show up as chronic symptoms. Those symptoms are often being labeled as “adrenal fatigue”, but the real issue is how your brain and adrenals are talking to one another.

What Causes Adrenal Dysfunction? 

Here’s the most straightforward answer: chronic or significant stressors can trigger HPA axis dysregulation and result in adrenal dysfunction. 

Common stressors that cause adrenal dysfunction include psychological stress, physical stress from food and lifestyle choices or chronic disease, and chronic inflammation caused by various issues including toxins and stealth (hidden) infections.

How Does Adrenal Dysfunction Impact Your Health?

I mentioned several roles your adrenal glands play, so adrenal dysfunction can show up in a variety of ways. 

But even if we focus specifically on how cortisol imbalances impact your health, we can see SO MANY different types of symptoms.

Imbalances in cortisol alone are enough to trigger multiple health issues and chronic symptoms that impact several systems in your body. 

Some of these imbalances include:

  • blood sugar dysregulation that can cause or worsen insulin resistance
  • increased intestinal permeability (“leaky gut”)
  • gastric (stomach) and duodenal (small intestine) ulcers
  • food intolerances
  • sleep disturbances (trouble falling or staying asleep)
  • low energy
  • weight gain
  • impaired liver detox
  • thyroid dysfunction
  • sex hormone imbalances (increased estrogen, decreased progesterone)
  • immune system suppression 
  • increased inflammation
  • promotion of autoimmunity
  • muscle wasting
  • decreased bone density that can lead to osteopenia and osteoporosis
  • mood imbalances like depression

Adrenals: The Second Tier of the Hormone Pyramid

The Hormone Pyramid is a way of organizing your hormones based on their importance and impact. You can read more about that here.

Blood sugar and insulin serve as the foundation of The Hormone Pyramid, which means that you HAVE to address blood sugar and insulin imbalances if you want to balance your other hormones. (I’ve got an article series on blood sugar and insulin regulation that you DON’T want to miss here.)

Your adrenal glands are the second tier of The Hormone Pyramid, and as you just learned, imbalances in adrenal function and cortisol output can affect many areas of your health, including your other hormones: insulin (blood sugar regulation), thyroid, and sex hormones.

Which means you’ll have a very hard time balancing those hormones if you aren’t optimizing the health of your adrenals!

The Blood Sugar – Adrenal Connection

You can read more about how your adrenals impact thyroid function and sex hormone balance here.

But since your blood sugar regulation and adrenal function are SO intimately connected, AND since they form the first two tiers of The Hormone Pyramid, let’s look more closely at this relationship.

How Blood Sugar Impacts Adrenal Function

When blood sugar drops (read more about that here), your body sees that as a stressor, so your adrenal glands are recruited. 

Your adrenals then respond by pumping out stress hormones, which tell your body to release stored glucose and raise your blood sugar.

This rise in blood sugar will cause your pancreas to release insulin to help get that blood sugar into your cells, where it can be used for energy. 

Over time, chronic recruitment of your adrenals to deal with low blood sugar can create dysfunction in how your brain talks to your adrenals, and in how your adrenals are behaving.

But high blood sugar also affects your adrenals. Blood sugar spikes leading to insulin surges (read more about that here) can directly impact your cortisol levels. This is because insulin surges and insulin resistance are inflammatory, and cortisol is a natural anti-inflammatory. If you’re dealing with more inflammation because of insulin surges or insulin resistance, your body may compensate by increasing cortisol in an attempt to lower inflammation.

Increased demand for cortisol because of the inflammation caused by insulin surges and insulin resistance can eventually strain the brain-adrenal axis and lead to adrenal dysfunction.

In other words, chronic blood sugar dysregulation can impact your adrenal health over time!

How Adrenal Function Impacts Blood Sugar

When you’re chronically stressed and have a maladapted stress response (HPA axis dysregulation / adrenal dysfunction), your adrenals can secrete levels of cortisol that are too low, too high, or a mixture of highs and lows, and this actually has a direct impact on your blood sugar. 

If cortisol secretion is inadequate, you can’t mobilize stored fuel as well. This can lead to low blood sugar, and you might experience fatigue between meals and notice better energy after eating.

On the other hand, excess cortisol secretion increases the mobilization of fuel and causes insulin resistance. The insulin resistance means glucose has a harder time getting into your cells, so this causes high blood sugar (because glucose is staying in the bloodstream). Typically this scenario causes fatigue after eating.

This means that chronic stress has the ability to cause blood sugar dysregulation and insulin resistance over time!

The intimate relationship between blood sugar regulation and adrenal function also means you cannot fix your adrenals unless you have stabilized your blood sugar patterns!

I’ve got more to teach you when it comes to adrenal dysfunction, so check out my articles Clues You Have Adrenal Dysfunction and How to Heal Adrenal Dysfunction!

In the meantime, make sure you read my Blood Sugar Series to learn how to address this foundational tier of The Hormone Pyramid:

  1. Why Your Blood Sugar Matters So Much
  2. How to Know if You Have Blood Sugar + Insulin Issues
  3. How to Reverse Insulin Resistance
  4. How Low Blood Sugar Causes Insulin Resistance

Want personalized guidance? Learn how my approach can help you optimize your health here.

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tree hugger, potato lover, health detective, empath, NATURE + science

Hi, I'm Mamie.
I'm a different kind of doctor.

I'll take the time to listen to your concerns, understand your whole health picture, teach you what your symptoms mean and why they're happening, and empower you to rebuild your health and care for your body. I'll help you reclaim your rightful place as the leading expert on YOUR health!

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