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What if everything you know about adrenal fatigue and HPA-axis dysfunction is wrong?
-This blog post was written by my holistic nutrition intern, Shereen Hirbod. Enjoy, and check out her bio at the end of the blog post!
Did you know that it’s possible for your brain to NOT be working and you be completely unaware of it? When your body and brain are not working up to par, over time you get used to it and it becomes the norm. It’s like a crab that is put in lukewarm water that is slowly brought to a boil. It never knows that it is dying. That’s what it was like with my chronic fatigue.
My “Adrenal Fatigue” journey
Essentially, I was dying a very slow death. This was my normal for several years. I would get sick, go to the doctor get antibiotics, then get over the illness very slowly. Repeat. I could barely function as a mom. Sadly, what I was going through was invisible.
My symptoms were:
- Extreme brain fog
- Trouble getting out of bed in the morning-exhausted despite 8 hours of sleep
- Extreme body pain that rotated areas of body
- Migraines-several migraine aura’s
- Sick every time a virus passed my path
- Faintness upon standing
- Inability to tolerate stress
- Feelings of complete overwhelm over the smallest tasks
- Trouble speaking or following conversation
- Pain in the eyes with bright light
- Extreme anxiety-elephant on chest, gasping for air
- Flu like symptoms
- Pressure in head as if it was pumped full of air
- Inability to tolerate smells/chemicals
- Poor digestion
- By 3-4 pm I was out of energy and would crash
Since there were no visible signs of what I experiencing, those around me couldn’t understand it.
I would try to push through because I thought, “Maybe it is just in my head”.
The doctor certainly made me feel that way. If you were given antidepressants 3 times after explaining the same symptoms, on three separate occasions, it would probably make you feel that way, too.
When your source of health care is not validating you, what are you supposed to do?
I decided to find a Functional Medicine Practitioner near me to figure it all out. I was sick and tired of being sick and tired.
I was diagnosed with “Adrenal Fatigue”. I was in my thirties, and though I was drained of mental and physical energy I was relieved. I finally had an answer and it was not a figment of my imagination!
But did I really have “Adrenal Fatigue”?
Getting my “Adrenal Fatigue” diagnosis
The practitioner listened to my entire story from childhood up to that moment, spending an entire hour with me. She told me she would run some tests, but pretty much suspected that I had “Adrenal Fatigue”. Omg! A doctor who wanted to run tests to find answers! Did I (almost) die and go to heaven?
A saliva test confirmed her suspicions that I had low cortisol levels throughout the day, with a steep drop at around 3 pm. This explained why I had such low energy levels.
Around this time, I came across the book Adrenal Fatigue the 21st Century Stress Syndrome by James Wilson (1998), and as I read it, I wept.
It all made sense! Of course, I had “Adrenal Fatigue”!
I marked off more than 30 of the symptoms and related stressors in the questionnaire!
So why had my primary care doctor not done the same test? Why had she given me antidepressants and made me feel like it was all in my head when, clearly, there is a test showing, I had Adrenal Fatigue, which is a very real and diagnosable syndrome?
As it turns out, my two different practitioners were both right AND both wrong at the same time.
Does “Adrenal Fatigue” exist?
When I started researching Adrenal Fatigue for this blog, the first definition I got was this one from the Mayo clinic website, which states:
“Adrenal Fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The term often shows up in popular health books and on alternative medicine websites, but it isn’t an accepted medical diagnosis. Signs and symptoms of adrenal insufficiency may include:
- Body aches
- Unexplained weight loss
- Low blood pressure
- Loss of body hair
- Skin discoloration (hyperpigmentation)
Adrenal insufficiency can be diagnosed by blood tests and special stimulation tests that show inadequate levels of adrenal hormones.
Proponents of the Adrenal Fatigue diagnosis claim this is a mild form of adrenal insufficiency caused by chronic stress. The unproven theory behind adrenal fatigue is that your adrenal glands are unable to keep pace with the demands of perpetual fight-or-flight arousal. As a result, they can’t 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.
It’s frustrating to have persistent symptoms your doctor can’t readily explain. But accepting a medically unrecognized diagnosis from an unqualified practitioner could be worse. Unproven remedies for so-called adrenal fatigue may leave you feeling sicker, while the real cause — such as depression or fibromyalgia — continues to take its toll.”
So essentially, the study says that, yes, symptoms are happening, but there is no such thing as “Adrenal Fatigue” as a medical condition because the adrenals do not actually get depleted. The “real cause” is depression or fibromyalgia, which are essentially allopathic terms for “It’s all in your head,” and, “You’re having body aches and we don’t know why, so we will make up our own name.”
Hello? Couldn’t they see that my symptoms and the ones I listed are almost identical? Yet doctors are telling me it’s not real? This is making me crazy!!
Were adrenal fatigue or depression my only diagnosis options?
So, to prove them wrong I looked up “Adrenal Fatigue” on google scholar and found a shock instead. In a 2016 systematic review of all the research related to adrenal fatigue, authors showed that adrenal fatigue is not a viable condition in that it has no real scientific diagnosis or testing that has confirmed it.
What the heck?
But the symptoms are real!! I have experienced them! How can you tell me this?
If it’s not my adrenals causing my silent, excruciating fatigue, then what the heck is it?
(Side-note. If you do have depression, see this blog series.)
That time they gave “Adrenal Fatigue” a new name: HPA-axis Dysregulation
It turns out that while my symptoms were very real, it wasn’t necessarily faulty adrenals that was causing them. I discovered that many people in the health community had come to this conclusion and abandoned the name “Adrenal Fatigue”, and replaced it with something a bit more complex.
The adrenals are just one organ affected in the dynamic of the body experiencing extreme forms of stress. A new coined term for the chaos that happens in the body under extreme stress is HPA axis dysregulation. This term contributes my symptoms to the connection between the hypothalamus, pituitary gland, and adrenals, which are the primary mode of regulation in the body during stress.
When stress is on hyperdrive, so is the HPA-axis. Under chronic stress and trauma, these three don’t shut off easily, leaving the body in a hypervigilant state.
This hypervigilant state of the HPA axis is sometimes (but not always) found in those suffering from “Burn Out” and “Chronic fatigue” (two fatigue-based conditions actually found in scientific literature).
So “Adrenal Fatigue” became “HPA-axis Dysregulation”, and that’s where most people in the health field landed on the subject.
But are they wrong, too?
The real cause of Chronic Fatigue
So, what was the real cause of my debilitating fatigue?
What I have learned from my time getting my Masters in Holistic Health Education at John F. Kennedy University, is that in this information-overload culture, you have to dig deeper to get to the truth.
In the past two years of studying nutrition, I’ve learned that the body is a complex system in a dynamic state. It is a powerful, efficient machine, constantly balancing and checking itself to keep you alive. I also learned just how much the modern body is bombarded with wrenches in the system that can alter, disrupt, and impact its efficiency.
While we are all looking for a simple solution to complex problems, the understanding of how our modern lifestyle, affects the energy source for our bodies, at the fundamental or cellular level, is crucial in getting to the root of the chronic fatigue problem.
What’s mitochondria got to do with it?
Everything! Do you guys remember mitochondria from 7th grade biology? You know, the “rod shaped power house of the cell”? *snicker snicker* The little guys that make ATP, or energy, for our body? Mitochondria are “life”. They provide the cellular process that forms ATP, without which many functions of the body cannot take place. Mitochondria are responsible for metabolism, cell signaling, aging, innate immunity, apoptosis, and cellular homeostasis.
What I discovered is that these little guys were hiding the answer to my problems all along!
Though the mitochondria are like the Mighty Mouse power house of the cell, they are susceptible to environmental, physiological, and chemical stressors that they are exposed to.
In my Master’s program, I had to do a presentation on mercury and its relationship to autoimmunity. I learned that mercury disrupts the function of the mitochondria by binding to its sulfhydryl group, which causes it to reduce its ability to produce ATP. Our modern exposure to toxins is one source of fatigue via reducing mitochondria function.
As it turns out, stress is another factor that affects mitochondrial function.
What is stress, at the level of the cell?
It doesn’t matter what the source of stress is, our bodies can’t tell the difference between physical, chemical, mental, emotional, or spiritual stress when it comes to our mitochondria.
Some possible modern sources of stress that can affect mitochondria, and therefore ATP are:
- Emotional or psychological trauma in childhood or adulthood, like Adverse Childhood Events, PTSD, CPTSD, and depression
- Spiritual stress, like feelings of loneliness and isolation, or negativity and pessimism
- Inflammatory conditions, such as chronic diseases, hormonal imbalances, poor gut function or leaky gut, or blood sugar imbalance
- Nutritional deficiencies (including calorie cutting diets)
- Environmental pollutants such as heavy metals, plastics, or pesticides and free radicals
- Inflammatory foods, like diets with sugar
- Pathogens like bacteria and viruses
- Physical injury
When environmental factors, as well as emotional psychological factors affect the function of our fundamental producer of energy in the body, is it any wonder that people are in a chronic state of fatigue in their lives?
I personally had emotional stress, psychological stress and trauma, heavy metal toxicity, pathogens, unavoidable exposure to endocrine disruptors (plastics), leaky gut, weight fluctuations, and genetic predispositions for sensitivities to these stressors.
I was the perfect host for mitochondrial dysfunction.
What I really had: Mitochondrial Dysfunction
I now realize is that Mitochondrial Dysfunction seems to be at the root of the physiological issues presented in so-called “Adrenal Fatigue” or “HPA-axis Dysregulation”.
In this podcast by fatigue expert Ari Whitten from the Energy Blueprint, CFS expert Dr. Sarah Myhill, discusses the topic of mitochondrial function. Dr. Myhill posits that lack of ATP production is the link to fatigue in mitochondrial dysfunction. She developed an “ATP profile” test to measure ATP production in patients suffering from CFS of which only 1 out of 71 fell into normal range.
Interestingly, low cortisol levels and HPA-axis Dysregulation, were only found in a subset of fatigue patients, while mitochondrial dysfunction was found in almost all fatigue patients!
This shows that mitochondrial dysfunction is a remarkable marker for fatigue.
Why are mitochondria so important?
Here is the breakdown. Mitochondria are responsible for several functions in the body, not just the production of ATP.
- Apoptosis: or programmed cell death as a means to control cell populations, or as a defense mechanism against pathogens.
- Autophagy: which is the destruction of damaged cells in the immune system, cancerous cells, damaged organelles, and pathogens during a nutrient-deficient state like fasting.
- Aging, cancer, and metabolism.
Ok, we get it. Mitochondria are important. But what does that have to do with stress?
How exactly does chronic stress affect the mitochondria?
When environmental factors, internal pathogens, inflammation, chronic conditions, and all the other stressors from the world we live in bombard the body, the mitochondria can purposefully stop making ATP and go into what is called Cell Danger Mode.
What is Cell Danger Mode?
To put it simply, if animals stay in a heightened state of stress, they go into shock and die. Their bodies are designed for short bursts of stress, followed by rest and relaxation. Our bodies are also designed that way. This is explained beautifully in the book called “Why Zebra’s Don’t Get Ulcers” by Robert M. Sapolsky.
When we experience unrelenting chronic stress, the mitochondrial metabolism and energy levels shut down.
Why should the body continue to produce energy in a body that is self-destructing? Wouldn’t that only push it into further decline?
Cell Danger Mode is the “slow-down” mechanism of the metabolism to reduce energy production, attributed to fatigue or lack of energy to the system for the system. It is also the reaction to a bioaccumulation of all the different types stressors to the mitochondria.
Cell Danger Mode is a type of hibernation where mitochondria no longer produce abundant energy because they are spending their resources dealing with chronic stressors. They shut down energy production as a means of protecting the body from over working itself.
When the resources for the body to maintain homeostasis has surpassed, or the demand exceeds supply, a cascade of events that result in a detrimental pathway that if not suspended and stopped can result in chronic disease. It is the pathogenesis of many chronic disease.
Essentially The body is saying: “STOP!”
So, what I was experiencing was fatigue to the point of dysfunction, because my body was telling me “NO”.
NO: you can’t keep ignoring my warning signs!
NO: you can’t keep putting inflammatory foods in me!
NO: you can’t keep exposing me to extreme emotional stress!
NO: you can’t keep this much mercury in your body!
NO: you can’t have this pathogen and expect me to work!
NO: you can’t expose me to pesticides in your food anymore!
NO: you can’t demand more energy from me without rest and relaxation!
NO: I won’t give you any more energy because you need to STOP!
When the mitochondria don’t function, the organs don’t either. Not the immune system, the digestive system, the endocrine system, nor any of the other systems of the body. All the dynamic process the mitochondria is responsible for are halted. It’s not death, but it feels like it. They all slow down so that the body had no choice but to stop.
Fatigue is all about the mitochondria!
Now I really, truly had answers! But knowing all this information, what the heck could I do about it?
The good news is that it’s not hopeless! We know how to support and increase the mitochondria!
How to support the mitochondria and stop Cell Danger Mode:
There are nutrients, supplements, and lifestyle choices that can support mitochondrial function. They not only can up mitochondrial function but also increase the number of healthy mitochondria in the body.
Nutrients and supplements for the mitochondria:
One of the best places to start recovering from mitochondria dysfunction is by adding mitochondria supporting foods and supplements.
Foods for the mitochondria:
Mitochondria require various vitamins, minerals, carbohydrates, proteins, and fats to function (for a full list, see this post).
Essentially a diet rich in good fats, seafood, clean grass-fed and pastured proteins, whole fruits and vegetables that are rich in phytonutrients, and mineral-rich sea vegetables are a great way to provide the mitochondria with what they need to function.
In general, some foods that are beneficial to the mitochondria are:
- Wild caught shellfish
- Pastured, organic animal protein
- Nuts and seeds
- Pastured, organic eggs
- Dark leafy greens (1-2 servings with each meal)
- Other veggies and fruits (6-10 servings each day)
Supplements for the mitochondria:
Lifestyle choices to support the mitochondria:
You have to sleep. And you have to sleep enough and at the right times. This allows our bodies to rest and recover, and aligns our bodies with their natural circadian rhythm. Some helpful strategies to improve sleep efficiency are:
- Getting in bed before 10 and waking up around 7
- Darkening your room with blackout curtains
- Wearing blue-light blockers and installing them on your electronic devices
- Blocking out noise with a fan or white noise machine
- Making sure the thermostat is still to 68 or below about an hour before you go to sleep
- Movement throughout the day each day
- Going outside throughout the day each day
- Using sleep-assisting herbs
- Not exercising within a few hours before bed (it heats up your body too much)
- Writing down your to-do list for the next day before bed so you don’t lay there and think about it
According to fatigue expert Ari Whitten, the best thing to do lifestyle-wise is to build resilience of the mitochondria with hormesis. Hormesis is essentially building the mitochondria’s energy “muscle” by building its resilience through small exposure to specific stressors. Such stressors include the following:
- Moderate exercise (read about how to exercise the right way here; it’s not what you think!)
- Intermittent fasting (read how to do that here)
- Carbohydrate and fats cycling (read about the healthy way to eat carbs here, and the healthy way to eat fats here)
- Cold exposure (cold showers, swimming in cold water, going outside when it’s cold)
- Heat exposure (aka, sun or saunas)
- Infrared light (aka, sun or saunas)
- UV light (aka, sun or UVB lights)
- Hypoxia (deep breathing with holding your breath)
- Caffeine cycling
- Phytochemicals (in other words, lots of colorful vegetables, fruits, herbs, and spices)
It’s important not to add hormetic stressors until your body is strong.
That’s why I listed foods first. You need to be eating good foods and sleeping enough before you add these small stressors. Otherwise you can send your body right back into cell danger mode. If you are just starting your recovery, you can do short walks and 15-20min in the sun daily until you are strong enough to add in more of these lifestyle strategies.
In addition, exposures to bioindividual inflammatory foods such as dairy, gluten, and processed foods, exposures to toxic chemicals such as VOCs, glyphosate in pesticide treated foods, BPA’s, and EMFs in cell phones and WIFI in the home must be reduced. This reduces the body’s overall chemical/toxic load to decrease the chances that your mitochondria will switch from energy making mode to cell danger mode. (see the link from the title for details on how to reduce your toxic load)
Check out this blog post on how Lori Rose Holistic recently recovered from her experience with burn out.
I know this information can be overwhelming at first. I’ve been there. Thankfully, our bodies are our gift to take care of so that we can live vibrant lives.
The fantastical physiology of our body knows when something is wrong, and it tells us. It is up to us to reconnect to our bodies and listen.
It is up to us to stop when it says to stop, and give it what it is telling us it needs.
Addressing physical and mental stressors like leaky gut, infections, nutrient deficiencies, and hyperactive stress are critical to ease the mitochondria out of Cell Danger Mode.
Supporting the mitochondria with phytonutrient-rich and nutrient-dense foods, as well as supportive supplements are crucial to help the mitochondria heal and function.
When we are feeling vulnerable with fatigue, diminished brain function, and overall lack of wellbeing, it is hard to reach out. However, I hope that this information I have shared can be a resource for those who are going through what I have gone through. To know you are not crazy or alone, it’s not all in your head, this experience is a real thing, and there is hope. You can heal and feel better and live a much better quality of life.
I have seen dramatic changes in my energy and health. You can too.
Know someone who might be struggling with cell danger mode? Share this post!
Guest blog post by:
My name is Shereen Hirbod. I have a BA in kinesiology from St. Mary’s College in Moraga and an MA in Holistic Health Education with a Specialty in Holistic Nutrition from John F. Kennedy University. I also am a certified Health Coach. My passion is working with people from a holistic perspective, encompassing all aspects of a person’s life to empower them in making changes in their health and well-being. As a health coach I use coaching tools, to validate, support, encourage, empower and hold accountable clients to attain the health and well-being they strive to achieve. As a Holistic Nutritionist, I do nutritional consulting that encompasses getting to the root causes of health concerns with the help of a thorough health history, from an evolutionary perspective. This includes blood chemistry, base line evaluations, and a nutrition plan, including nutritional supplements to reach vibrant health. I do not diagnose nor am I medical practitioner. I believe in the power of nutrients from whole foods, a healthy way of eating, as well as a holistic perspective covering mind, body, and spirit to bring about health and well-being.
Make sure you don’t miss future posts from Lori Rose Holistic:
I make your health my priority so you can make your dreams your priority!
Lori Valentine Rose, PhD, CNP, BCHN, FDN-P, RH (AHG), NBC-HWC, is a college biology, nutrition, herbal, and wellness instructor, national board certified nutrition professional and holistic nutrition consultant, Functional Diagnostic Nutrition® Practitioner, board registered herbalist, national board certified health and wellness coach, wife, mother, organic vegetable, fruit, and medicinal herb gardener, school garden planter, city class teacher, and passionate Zumba dancer! She created, developed, and instructs the Hill College Holistic Wellness Pathway, the most thorough, affordable, degreed wellness program in the country. She also has a video podcast here where she interviews people that have helped her truly embrace real mind-body-spirit holistic wellness. She loves spreading love and light, and helping others feel awesome on the inside and out so they can live their dreams and make this world more awesome! Lori Rose Holistic does not replace medical advice or working with your doctor, and she does not diagnose, treat, or cure disease. Her goal is to educate, and any actions you take are voluntary and of your own free will.
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