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  • Ellen Brown L.Ac. DACM

Tired of being tired – 20 signs you may have adrenal fatigue

Updated: Aug 21, 2020

The adrenal glands mobilize the body’s response to every kind of stress – be it physical, emotional or psychological – through hormones that regulate energy production and storage, immune function, heart rate, muscle tone, and other processes that enable us to cope during challenging times. Whether it’s an emotional crisis like the death of a loved one, a physical crisis such as surgery, or any type of significant, ongoing pressure in your life, the adrenals are responsible for helping us manage stress and maintain homeostasis. A chronic illness, life crisis or abusive relationship can drain the adrenal resources of even the healthiest person.

We each have two adrenal glands that sit above our kidneys. Their function is to keep us alive during dangerous times by increasing our strength and speed. Whenever the adrenals are stimulated by stress, they respond by flooding the body with hormones (including cortisol, adrenaline and epinephrine), to increase blood pressure, boost our energy, slow digestion and shut down executive brain function – all to help us better deal with the threat. Collectively, these changes – known the stress response – have evolved over centuries to protect us from predators and other immediate dangers. By preparing the body for “fight or flight” this automatic response provides us with the short-term advantage of being slightly stronger, more alert and ready to take action.

Unfortunately, the adrenals were not designed to react to the constant pressure and stress that now define our modern lifestyle. If you were being chased by a tiger, “fight or flight” would kick in immediately to provide a short burst of energy to allow you to escape. Now imagine that tiger has been relentlessly following you for weeks, or even years. In today’s world, stress is the tiger. And for many of us living under its relentless onslaught, our body’s natural alarm system has gotten permanently stuck in the “on” position, eventually draining the adrenal glands. When the adrenal glands are constantly required to sustain high cortisol levels because of our relentlessly stressful, modern lifestyle, they tire out, unable to effectively respond to difficult situations. Adrenal fatigue occurs when the adrenal glands can no longer meet the demands of stress in your life – no longer able to “reset” – and no longer produce adequate levels of hormones that the body uses to communicate and function.

Adrenal fatigue (AF) is associated with a wide range of physical and emotional symptoms – more accurately called a “syndrome” – that occur when the adrenal glands and HPA axis function at below-optimal levels. Overtime, the effects of excessive work, high stress, little vacation, face-paced lifestyle, poor diet and environmental toxins lead to adrenal gland dysfunction, with symptoms that often include:

Chronic fatigue

Not surprisingly, the most common symptom of adrenal fatigue is fatigue. Unlike regular tiredness that you might experience on any given day, this is the kind of fatigue that isn’t improved with a good night’s sleep. With AF, many sufferers feel tired all the time, never fully refreshed by sleep and chronically exhausted.

Early mornings are impossible

When you have adrenal fatigue, mornings are the hardest time of day and getting out of bed can feel like an impossible challenge. People suffering with adrenal fatigue don’t experience a normal cortisol awakening response. Too-low cortisol levels in the morning fail to provide the energy you need to start to the day. This feeling is often followed – and further reinforced – by anxiety about not having enough energy to make it through the day with all of its demands. AF throws the cortisol cycle off balance, making it difficult to sleep at night and rise in the morning.

Wired, but tired, at night

Disrupted levels of cortisol wreak havoc with your energy levels through out the day when you have AF. Many people who suffer with adrenal fatigue find that their energy – ironically – seems to pick up at night when they should be asleep. This is because cortisol spikes during the evening (when it should shut down), making it difficult to wind down at the end of the day or stop circular, obsessive thoughts that make it impossible to shut the mind off so that you can go to sleep.

Afternoon slump

Many who suffer with AF often experience an afternoon “low” each day as their cortisol – and energy – drop between 2:00 – 4:00 pm. At this time, when hormones dip, your thinking may be clouded and you may feel like crawling under your desk for a nap.

Stubborn weight gain and belly fat

If you’ve recently gained weight despite careful attention to diet and exercise, it may be because your adrenal health is below par. Women with AF often gain weight around their mid-section. After months or even years of chronic stress, cortisol and insulin remain high in the blood, with extra glucose being stored as unwanted fat, mostly in the abdomen and thighs. More recently, research has found that not only do fat cells have special receptors for cortisol, but these receptors are much more prevalent on the fat cells in the abdominal area. In addition, a sleep-deprived body produces more ghrelin, the hormone responsible for telling you to eat. Ghrelin production is your body’s way of telling you to find energy in the form of calories.

Chronically sick

Despite its many and various symptoms, one of telltale signs of AF is a compromised immune system that leaves you much of your time fighting off illness. When cortisol levels remain consistently high (as they can be with many people fighting early stage adrenal fatigue), the immune system can’t keep up the pace. This leaves you vulnerable to a wide range of viruses, illnesses and infections that become harder and harder to bounce back from. Over time, as inflammation takes over, allergies may worsen, autoimmune diseases may occur, and depression may set in.

Unexplained muscle pain and weakness

If being exhausted all the time wasn’t bad enough, adrenal fatigue often produces tension throughout your body, leaving the thighs, knees and low back feeling weak and achy. Diffuse joint pain and muscle stiffness/weakness are common among AF sufferers. You may also notice the loss of muscle tone and have unexplained sore muscles (including fibromyalgia).

Easily overwhelmed

When you’re struggling with adrenal fatigue, your body (and mind) often isn’t up to the challenge of handling everyday tasks that most people take for granted. After long periods of stress, we lose the ability to produce sufficient amounts of adrenaline, norepinephrine and cortisol – the hormones we all rely on to provide the energy we need to get through a demanding day. An imbalance of these stress hormones, along with inadequate sleep, creates a vicious cycle that can leave you feeling edgy and short-tempered. Emotions often become fragile, causing you to over-react to small events or blow things out of proportion. Some people with adrenal burnout actually function on anger and resentment, which can act as adrenal stimulants to provide much needed energy.

Anxious yet unenthusiastic

Many people suffering with adrenal fatigue find it difficult to cope with stressful situations or “rise” to meet important occasions or challenges. Because they lack sufficient stress hormones, they report feeling strangely “flat” when they know they should be excited. Maintaining the acute focus and high energy levels that stressful situations require becomes a struggle. Many report feelings of listlessness, apathy, despair, or a kind of emotional “numbness.” They suffer a loss of enthusiasm for things they once enjoyed, as well as a loss of interest in old friends, family and work.

Frequent anxiety and depression

Depression and apathy are common in adrenal burnout. AF leaves many people feeling easily overwhelmed by their emotions in response to even minor stress or conflict, making it difficult to keep up with daily obligations. As the drain on the adrenals continues and gets worse, insufficient hormone levels make it difficult to “lift” yourself from feelings of sadness or depression.

Brain fog and poor memory

The same disruption of the cortisol cycle that makes it so difficult to get up in the morning with energy to face the day is also at the root of forgetfulness and an overall decline in cognitive ability. This type of mental fogginess can make it difficult to stay focused on the task at hand or leave you with chronic, racing thoughts that you can’t seem to control.

Craving salty foods

The part of the adrenals called the cortex is responsible for producing aldosterone, the hormone that helps the kidneys regulate our fluid and mineral excretion. When the adrenals become fatigued, we produce less aldosterone and tend to excrete large amounts of important minerals in our urine. Overtime, AF sufferers will lose the ability to balance mineral levels such as sodium, potassium and magnesium in their blood, generating fierce cravings for foods that can replace the sodium we’ve lost, like chips, pretzels and popcorn.

Dependence on your sunglasses

Many with AF find it all-but-impossible to be out in the bright, midday sun without their sunglasses. Oversensitivity to bright sunlight is a sign of adrenal problems due to a chronic sodium-potassium imbalance that prevents the pupils from properly constricting in response to bright light.

Can’t get going without coffee

For many people suffering with AF, caffeine and other stimulants eventually become the only way to get going in the morning. This temporary, artificial boost of energy is deceiving, of course, and fleeting – increasingly requiring a second and even third cup of coffee to produce the same effect.

Decreased libido

The hormone imbalance that is a central issue in AF goes beyond stress response to also include a decline in sex drive as well. As the adrenals first start to weaken, they “cope” by reducing the production of sex hormones in order to allow stress hormone production to stay elevated (this is called the “pregnenelone steal”) that ultimately robs you of your sex drive.

Difficult and disrupted menstrual cycle and menopause

Adrenal hormones are involved in the menstrual cycle and it is common for women with adrenal fatigue to have irregular menstrual cycles or even have their cycles completely stop – indeed, stress is known to affect the menstrual cycle.

The adrenal glands are the only source of testosterone in women, and after menopause are the only source of the female hormones, estrogen and progesterone. When women enter perimenopause and menopause, the ovaries slow their production of estrogen and progesterone, and the adrenal glands have to pick up the slack for menopause to proceed smoothly. If the adrenals are already fatigued, it may be more difficult to meet this extra demand for hormone production. In fact, the adrenals may become even more depleted as a result, creating a vicious cycle.

Digestive issues

Elevated cortisol levels impact how your digestive system functions, impairing the body’s ability to properly digest food. If your body isn’t getting the nutrition it needs, or if you’re eating in a way that creates drastic blood sugar fluctuations, you’re punishing your adrenals. Even worse, bloating and poor digestion are also signs of adrenal fatigue, so your food choices and stomach issues can either be a cause or sign of the condition.

Dizzy and light-headed

Low blood pressure may leave you feeling light-headed or dizzy when you first get up from a sitting or laying down position. Moreover, low blood-glucose levels can cause loss of balance and even fainting spells.

Low body temperature

People suffering with AF often feel cold no matter what the temperature is, and will often keep a sweater on when everyone else is in short sleeves. Because AF is often marked by low body temperature and a decreased tolerance to cold, your hands and feet may feel noticeably cool.

Dark circles under the eyes

Sure, dark circles under the eyes are often associated with not getting enough sleep. But more than that, dark circles appear when stressors such as fatigue, emotional overload or dehydration (which is physically stressful for the body) disrupt healthy blood circulation – which reveals itself through the thin skin under your eyes.

Because of its far-flung effects, adrenal fatigue can wreak havoc on almost every system in your body and every aspect of your life. Changes occur in our carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. Many other changes take place at the biochemical and cellular levels in response to – and to compensate for – the decrease in adrenal hormones that occur with adrenal fatigue. As your body tries to compensate for under-functioning adrenal glands, it pays a high price.

Importantly, you can’t “spot-treat” your hormones. We’ve become accustomed to this type of thinking from western medicine, which offers penicillin for an infection, ibuprofen for a headache. Instead, AF must be approached holistically, examining every aspect of lifestyle – diet and exercise, relationships and sources of stress, sleep patterns, sources of stimulation and relaxation, and so much more – to eliminate its root cause a well as relieve its profound symptoms. Acupuncture effectively treats the adrenal glands and their “master” gland, the kidneys. Not only are the adrenals directly supported through acupuncture, but acupuncture is famous for its ability to raise endorphin levels that are depleted by stress and are needed to help regulate cortisol. Moreover, acupuncture is incredibly relaxing, to help treat the root trigger of adrenal fatigue, stress.

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