Dr. Jacquelyn Paykel
Home >> Gynecology >> Adrenal
Gynecology & General Health
                                                            What is Adrenal Fatigue?

Adrenal fatigue – this is a controversial subject.  The adrenals are little organs that sit on top of
your kidneys.  They are each about the size of a walnut.  The adrenal glands:
1.  Secrete epinephrine – also known as adrenaline.  This happens in time of crisis.  This causes
the fight or flight response during stressful situation: dilate your air passages, get your heart
pumping, increase the blood flow to your muscles, increase your ability to concentrate.  
2.  Secrete cortisol – this regulates the metabolism of fats, proteins and carbohydrates to maintain
the blood sugar within an optimal range so that energy is available for the body’s use
3.  Create aldosterone and sex hormones DHEA and DHEAS

Q:  What is Adrenal Fatigue?
Adrenal fatigue is a mild form of adrenal insufficiency caused by chronic stress – whether from
stressful life events or a medical illness. The theory behind adrenal fatigue is that your adrenal
glands are unable to keep pace with the demands of perpetual fight-or-flight arousal and cortisol
release. As a result, the adrenals are unable to produce quite enough of the hormones you need to
feel good. Existing blood tests, according to this theory, aren't sensitive enough to detect such a
small decline in adrenal function — but your body is. That's why you feel tired, weak and depressed.

Q:  Who suffers from adrenal fatigue (AF)?
People who chronically
Lack sleep,
Make poor food choices (pro-inflammatory diets)
Use food and drinks as stimulants when tired
Those who work or live in stressful environments, especially if they feel powerless
Type A personalities – as perfection is difficult if not impossible to achieve
Very driven people
Those who do not engage in enjoyable and rejuvenating experiences

Q:  Which occupations or lifestyles are more likely to lead to AF?
College students
Mothers of multiple young children who do not have adequate support from family and
Single parents
Individuals in unhappy relationship
Those who work in stressful situations day after day
Self-employed individuals just starting a business
Those who abuse substances
Those who do not have established sleep schedules (shift workers)

Q:  Are there certain life events that could lead to AF?
Frequent crises at work or home
Severe emotional trauma
Death of a close friend of family
Major surgery
Repeated or overwhelming chemical exposure
Head trauma
Prolonged respiratory illnesses
Loss of stable job, sudden change in financial status
Relocation without support

What are the signs or symptoms of adrenal fatigue?
Difficulty getting up in the morning (not feeling rested)
Fatigue that is not relieved by sleep
Craving salty foods
Lack of energy
Decreased sex drive
Decreased ability to handle stress
Taking a prolonged time to recover from an illnesses
Lightheaded when standing up quickly
Mild depression
Less enjoyment or happiness in life
Increased symptoms of PMS
Worsening symptoms with missed meals
Fuzzy thinking and memory loss
Particular energy patterns:
                    Don’t really wake up until 10:00
                    Sleepiness between 3:00 and 4:00
                    Feeling better after evening meal
                    Late night surge after 11:00 pm

Q:  How is AF diagnosed?  
Adrenal fatigue is diagnosed through obtaining a pertinent history, physical exam and salivary testing of cortisol, DHEAS and blood sugar.
It is a diagnosis of exclusion meaning that we rule other disease processes such as depression,
generalized anxiety, thyroid dysfunction,  severe diseases of the adrenal glands, sleep apnea and

Conventional medical answer:  There is no test that can detect adrenal fatigue.  Many times, a
person will be told he or she has adrenal fatigue based on symptoms alone. Sometimes, a blood
or saliva test may be offered (but tests for adrenal fatigue are not based on scientific facts or
supported by good scientific studies).

Q:  Do conventional medical providers even acknowledge adrenal fatigue as a syndrome or
disease process?
No.  Admittedly, it is controversial.  However, just because you can’t test for it, does not mean it
does not exist.  An indirect assessment is the measurement of a diurnal salivary cortisol level.  If
the symptoms are there, and you have undergone all the tests to evaluate for other disease
processes then AF syndrome should be given consideration.

Q:  So, if a person thinks they may have adrenal fatigue, how do they hook up with a provider
who will actually help them with their symptoms?
Integrative medicine providers
Complementary providers such as chiropractor, some nutritionists
Alternative providers such as homeopaths, naturalists, ayurvedic providers

Q:  What is the underlying disease process that causes adrenal fatigue?
Chronic stress of body (disease), mind, or spirit

Q:  What can we do to help ourselves recover from AF?
Food: organics, vegetables, omega three fatty acids, low fat proteins, healthy fats; pay
attention to glycemic load; try to limit refined sugar, trans and saturated fats
Understand your food sensitivities and allergies through an elimination diet  
Drink: eliminate fruit juices, alcohol and caffeine; increase green tea
Supplements:  Melatonin 3 mg taken 3o minutes before bed; Calcium citrate 1000 mg daily,
Vitamin C, vitamin E, B complex,
Botanicals: valerian, hops, Kava, licorice, chamomile, ashwagandha, ginger, ginkgo,
Rest – be in bed before 10:30 and when you can sleep past 9:00
Exercise – 30 minutes of aerobic exercise daily, stretching exercises
Change your Environment – get outside, back into nature
Mind-body changes – relaxation techniques, belly breathing, intentionally paying attention to
your breathing, affirmations, counting your blessings, progressive relaxation
Unstructured times - spend a day, week or month without an agenda.  Turn off the
electronics, and just be in your silence, or read an uncomplicated book or draw or fish or do
whatever eventually allows to turn the monkey brain off.
Helpful Links
Recommended Reading
Following is a excerpt from a TalkShoe Podcast Dr. Paykel hosted on the subject of Adrenal Fatigue.  
Her guest is holistic nurse practitioner, Cherri Schleicher.