Feeling tired lately? Not just want-to-go-to-bed-early tired, but so weary that you struggle through your workouts or can scarcely muster the energy to drive to the gym or tie your shoes for a run? Depleted cortisol levels may be to blame.
Cortisol is a hormone secreted by the adrenal glands, small triangular glands located on top of both kidneys (see illustration below). Cortisol’s main job is to mobilize your body’s response to physical, emotional or psychological stresses, whether they arise from an injury, from a bad day at work or from an awful commute. Hence cortisol’s reputation as “the stress hormone.”
Cortisol is powerful stuff, and great to have available in a pinch. Get overly stressed on a regular basis, though (a condition known as chronic stress), and your adrenal glands go into overdrive. They obligingly churn out increasing quantities of the hormone, which tends to inhibit the release of other hormones, including many of those that are key to digestion and healing.
Having constantly elevated cortisol levels can, over time, lead to a variety of ailments, including weight gain and a weakened immune system. And eventually, if your overtaxed adrenal glands go too long without getting a chance to rest and recuperate, they can get worn out — so worn out that they lose their ability to create even normal, baseline levels of cortisol. The result? You get fatigued. Very fatigued.
A “Real” Problem?
Ask your doctor about adrenal fatigue and you may just get a blank stare or be told it doesn’t really exist. This is because mainstream medicine does not yet recognize adrenal fatigue as an official health condition.
“The conventional medical model is a disease-based model,” explains James Wilson, ND, DC, PhD, author of Adrenal Fatigue: The 21st Century Stress Syndrome (Smart Publications, 2002). “But adrenal fatigue isn’t a disease — it’s a subfunctioning of the adrenal glands.” And so, he explains, the condition isn’t even on the radar of many conventional docs.
There is a recognized disease in which the adrenal glands fail almost completely: Addison’s disease, which affects about one in 100,000 people. Doctors treat it with synthetic cortisol and diagnose it with a simple clinical test in which they inject patients with ACTH — the body’s chemical signal to release cortisol — and then measure the strength of the ensuing cortisol response.
The problem with this test, according to Wilson, is that it’s all or nothing. Only patients who are found to be almost incapable of producing cortisol are diagnosed with Addison’s disease. Everyone else, including anyone whose adrenal glands are quite weak, but not weak enough to be life-threatening, is considered healthy. In other words, “You’re normal until you take one more step off the cliff and then ‘suddenly’ you have Addison’s disease,” says Wilson.
This loser-take-all diagnosis may soon change, though, with preventive treatment methods becoming more widely embraced. Medical researchers are now observing chronically low cortisol levels (called hypocortisolism) in patients with a host of stress-related diseases and disorders other than Addison’s disease. These include posttraumatic stress disorder, chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis, asthma and even some allergies.
Symptoms and Solutions
Wilson notes that long before it causes disease, adrenal fatigue can produce a host of disruptive signs and symptoms. In addition to persistent fatigue, these include subclinical depression, low sex drive, hypoglycemia (low blood sugar) and weakened immune response to infections. “The symptoms of adrenal fatigue are many and varied,” Wilson explains, “because cortisol goes to virtually every part of the body. So when cortisol levels drop, lots of different systems are likely to be affected. There’s no single sign or symptom that indicates, ‘Aha! We have adrenal fatigue.’”
One of the most frustrating aspects of adrenal fatigue is that its dragged-down symptoms can do a real number on your fitness regimen. When you’re feeling tired, depressed or always fighting off a cold, maintaining your workout routine can be darn near impossible. But ironically, the best way to fight adrenal fatigue is to — you guessed it — exercise.
Moderate exercise not only strengthens weakened adrenal glands but also stimulates the immune system, eases stress, improves mood and addresses just about every other direct and indirect consequence of adrenal fatigue, according to Wilson. A study in the journal Endocrinology (July 2003) found that regular exercise increased the size and cortisol output capacity of the adrenal glands in mice.
But not just any type of exercise will do. Wilson suggests a moderate program that equally balances cardio and strength training. The general consensus is that although both types of exercise have been shown to increase cortisol production individually, a tag-team approach is likely to be most beneficial.
Breaking the Cycle
Working out can be difficult if you already suffer from adrenal fatigue, because you simply may not feel that you have the energy. So it’s important that you do whatever you can to overcome that inertia.
To begin with, “exercise at a time of day when you tend to feel comparatively good,” Wilson says. It may sound obvious, he notes, but it’s importantbecause people with adrenal fatigue tend to experience a consistent fatigue pattern, with highenergy points around noon and 6 p.m. By timing your workouts to coincide with your personal high points (whenever they occur), you can break the Catch-22 cycle that keeps you down.
You also need to closely gauge your reaction to your workouts and adjust them as needed. For instance, if you suddenly hit the wall in the middle of a particular session, don’t push yourself. Do a shorter or easier workout than the one you planned, or, if necessary, call it a day, rest up and try again tomorrow. If you’re finding that your typical training sessions are taxing you more than usual, cut back. “If you become inordinately fatigued within 90 minutes after your workout,” notes Wilson, “or if you’re more tired the next morning after a workout, that’s a sign you’ve overdone it.”
Finally, try to maintain the frequency of your exercise. Aim for easy workouts that allow you to train at least four times a week. Gradually, as your adrenal glands recover, you’ll be able to do longer and more intense workouts. And that will help bring your whole body up to speed.