Adrenal fatigue is caused by continual over stimulation of the adrenal glands from constant stress. The adrenal glands have difficulty keeping up with the constant demands and become limited in their ability to adapt too many stressors. This manifests as a number of symptoms, one of which is exhaustion that doesn’t resolve with the typical rest and relaxation.
Typically, most people adapt well to the stresses of life. However, as we continually place increased demands on ourselves, our adrenal glands are constantly stimulated to produce stress hormones as our bodies’ way of coping. As the stressors continue and less time is allowed for sleep and rest, ‘adrenal fatigue’ is often the result.
Adrenal fatigue occurs when a person is unable to continue with their customary level of activity. This is marked by a continual deterioration of everyday functioning. Depression and decreased performance are hallmarks of adrenal fatigue. Other key symptoms include difficulty sleeping, difficulty waking up in the morning, feeling unrested, decreased energy, fatigue, and increased injury and difficulty healing. One of the hallmark clinical observations is that of elevated or depressed cortisol levels.
What is cortisol?
Since many symptoms of ‘overtraining syndrome’ are similar to that of adrenal fatigue it is important to understand the how’s and why’s of a key adrenal hormone – cortisol.
Cortisol is a hormone produced by your adrenal glands. It falls into a category of hormones known as glucocorticoids? This refers to their ability to increase blood glucose levels. Cortisol is the primary glucocorticoid.
Why does your body produce cortisol?
Cortisol is a stress hormone. Your body produces cortisol in response to physical, mental or emotional stress. This can include extremely low calorie diets, intense training, high volume training, lack of quality sleep, as well as common daily stresses such as job pressures, fights with your spouse or being caught in a traffic jam. Trauma, injury and surgery are also major stressors to the body.
What does cortisol do?
Cortisol is part of the fight or flight response. Faced with a life or death situation, cortisol increases the flow of glucose (as well as protein and fat) out of your tissues and into the bloodstream. This is done in order to increase energy and physical readiness to handle the stressful situation or threat. Remember the story of the child trapped under a car and the mother lifting the car to release the child? This was the “fight or flight response” in action.
How do you know whether your cortisol levels are high?
The simplest and most efficient way to know for sure is to get your cortisol levels tested. The most common method of testing is a blood test (blood cortisol levels). Saliva and 24 hour urine tests are also available.
Should you get your cortisol levels tested?
For serious competitive athletes, it may be worth the time, expense and inconvenience to have cortisol tests done on a regular basis. Some strength and conditioning coaches insist on it. For the average trainee, as long as you are aware of the factors that produce excessive cortisol and take steps to keep it in the normal, healthy range, then testing is probably not necessary.
What is a normal level of cortisol?
Cortisol levels fluctuate depending upon age, sex, and time of day. They are higher in adults than children and levels fluctuate throughout each 24 hour period, so tests must account for the time of day. Cortisol concentrations are highest in the early morning and they are also elevated after exercise (a normal part of your body’s response to exercise). The lowest levels are usually around midnight. According to the Medline Encyclopedia, normal levels of cortisol in the bloodstream at 8:00 a.m. are 6-23 mcg/dl.
Does cortisol make you fat?
No, cortisol is not the thing that makes you fat. In fact, one of the effects of cortisol is to increase the breakdown of stored adipose tissue into glycerol and fatty acids where it can enter the bloodstream and then be used as energy. High levels of cortisol are merely one contributing factor to storage of abdominal fat, not the primary cause. An excess of calories from too much food and not enough exercise is one of the major dynamics contributing to excess fat.
Does stress make you fat?
No. If it did, then everyone who is stressed would be gaining fat. Many people lose weight while under stress. In some studies, test subjects with the highest cortisol levels lost the most weight. Stress by itself does not increase body fat. However, if stress stimulates appetite and leads to overeating then the excess calories from stress eating can make you fatter.
Is cortisol related to abdominal obesity?
Yes. There is a link between high cortisol levels and storage of body fat, especially visceral fat. Generally speaking there are two distinct types of fat. First, there is abdominal body fat (also known as intra-abdominal fat). This fat is also known as regular fat and is stored below the skin (known as subcutaneous fat). Next there is visceral fat, which is stored deeper in the abdominal cavity and around the internal organs. Visceral fat is particularly unhealthy because it is a risk factor for heart disease and diabetes.
Is cortisol bad for you?
Cortisol, in and of itself, is not bad for you. It is a hormone that is essential for life as part of our natural stress response. There are many hormones in our bodies, which in the proper amounts, maintain good health, but in excess or in deficiency, contribute to health problems. Cortisol is no different. The goal is to maintain a healthy normal level of cortisol. It is not suppress your cortisol to nothing or allow it to remain elevated.
Chronically elevated cortisol levels may have a variety of negative effects. Cortisol is catabolic and elevated cortisol levels can cause the loss of muscle tissue by facilitating the process of converting lean tissue into glucose.
An excess of cortisol can also lead to a decrease in insulin sensitivity, increased insulin resistance, reduced kidney function, hypertension, and suppressed immune function, reduced growth hormone levels, and reduced connective tissue strength. Chronically elevated levels of cortisol can also decrease strength and performance in athletes.
Two classical examples of cortisol related abnormalities are Cushing’s syndrome and Addison’s disease. Cushing’s syndrome is a disease of high cortisol levels, while Addison’s disease is a disease of low cortisol levels.
Can suppressing cortisol improve your muscle growth and strength?
High cortisol levels can increase muscle protein breakdown and inhibit protein synthesis (building up muscle proteins), so a chronically elevated cortisol level is clearly counterproductive to building muscle. Bringing elevated cortisol levels back to normal may improve recovery, strength, hypertrophy and performance.
However, there is no available scientific evidence that reducing your cortisol levels below normal will have any effect on increasing muscle growth. So at this point getting your cortisol levels below 6 mcg/dl is of no apparent value.
How can you lower your cortisol levels naturally?
If you are over trained, unnatural cortisol suppression may be nothing more than a band aid. In fact continued overtraining can lead to adrenal exhaustion, which could take months to remedy. Sometimes the best thing you can do is take a rest or decrease your training volume and intensity rather than artificially attempt to suppress cortisol. Symptoms of overtraining include elevated resting pulse, sleep disturbances, fatigue, decreased strength and decreased performance.
There are some very simple and easy techniques for lowering or maintaining optimal cortisol levels:
- Avoid very low calorie diets, especially for prolonged periods of time. Low calorie dieting is a major stress to the body. Low calorie diets increase cortisol while decreasing testosterone.
- Use stress reduction techniques (stress, anger, anxiety, and fear can raise cortisol)
- Avoid continuous stress. Stress is an important part of growth. It’s when you remain under constant stress without periods of recovery that you begin breaking down.
- Avoid overtraining by keeping workouts intense, but brief (cortisol rises sharply after 45-60 min of strength training).
- Avoid overtraining by matching your intensity, volume and duration to your recovery ability. Decrease your training frequency, and or take a layoff if necessary.
- Suppress cortisol and maximize recovery after workouts with proper nutrition: Consume a carb-protein meal or drink immediately after your workout.
- Get plenty of quality sleep since sleep deprivation is a stressor and can raise cortisol levels.
- Avoid or minimize use of stimulants; caffeine, ephedrine, synephrine, etc. Keep hydrated and get plenty of sleep.
- Limit alcohol since large doses of alcohol elevate cortisol.
- Stay well hydrated. Some studies suggest that dehydration may raise cortisol.
Treatment of adrenal fatigue
Once adrenal fatigue is suspected a number of effective treatments are available. Most providers will start by assessing your symptoms and doing baseline testing. They will talk to you about why you are experiencing the symptoms you have and what you can do about it with nutrition, lifestyle, and how specific supplemental therapy can help.
The type and duration of treatment will vary from patient to patient since each person’s clinical symptoms and situation will differ. For the most part however, adrenal fatigue is typically treated using a combination of nutraceuticals (specific professional grade nutrients), herbal remedies, and replacement hormones.
Lifestyle adjustments may have to be initiated depending on the individual. In highly active athletes sometimes a reduction in training for a period of time may be part of the treatment; while in sedentary people; light exercise may be part of the prescription.
Once you’re on your way to recovery it is important to communicate regularly with your health care provider. They may recommend follow up testing to verify that the recommendations are having the optimal impact on your condition and your health.