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The REAL Causes Of Low Cortisol Levels and How To Fix It

As we covered in Part 1 on debunking adrenal fatigue, it is clear that:

  • Chronic stress does not “fatigue” our adrenals and cause low cortisol levels.
  • Chronic disease (or really any measurement of poor health status or total body stress load) also does not “fatigue” our adrenals and cause low cortisol levels.
  • “Adrenal fatigue”/low cortisol levels are NOT the cause of the symptoms of stress-related fatigue/burnout/exhaustion.

In this article and video/podcast, we’re going to cover the exact specific factors known to cause (or be reliably associated with) low morning cortisol levels.

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If Not “Adrenal Fatigue”, Then What’s Really Going On In People Who Have Low Morning Cortisol Levels?

First, let’s get clear on what type of cortisol findings we’re actually talking about that get people diagnosed with “adrenal fatigue.”

We’re NOT talking about severely low 24-hour output of cortisol levels, which is likely indicative of Addison’s Disease. That is extremely rare and has basically nothing to do with “adrenal fatigue” or stress-related exhaustion/burnout.

The vast majority of people who are told they have “low cortisol” or “adrenal fatigue” have not actually been determined to have low total 24-hour output of cortisol.

What the vast majority of these people – more than 90% (conservatively) — have is SLIGHTLY lower morning cortisol levels and sometimes also SLIGHTLY higher evening cortisol levels. This is also called a “flattened diurnal cortisol curve.”

This means that a person will typically have slightly lower morning cortisol levels (when cortisol should be higher) and sometimes also slightly higher cortisol levels in the evening (when cortisol should be lower) – as compared with people with an ideal cortisol rhythm.

As I showed you in Part 1 (Debunking adrenal fatigue), while this pattern often gets people diagnosed with “adrenal fatigue”, the reality is that the science does not support the notion that this cortisol pattern is caused by “adrenal burnout” or any sort of actual inability of the adrenal glands to produce enough cortisol (as the “adrenal fatigue” theory proposes).

Indeed, unpublished research from a lab that does cortisol testing called Precision Analytical found that in 2,000 people with low morning salivary cortisol levels, when total cortisol production is measured via the urine, 85% of those people actually had normal or even high total cortisol production! [i]

Put another way:

  • Only 15% of people being told they have “low cortisol levels” (and likely being diagnosed with “adrenal fatigue”) actually have low cortisol production!
  • The vast majority of people with low morning cortisol levels do not have any deficit in the ability of their adrenals to produce cortisol. They have perfectly normal total cortisol output.
  • And many people being diagnosed with “adrenal fatigue” and told that their adrenals aren’t producing enough cortisol are in reality, producing abnormally HIGH amounts of cortisol over 24 hours.

So even where someone has low morning cortisol levels and this “flat diurnal curve” of cortisol, that should not be interpreted as or “adrenal fatigue” or “adrenal burnout.” This finding is almost always not the result of any actual problem with the adrenals or inability to produce enough cortisol.

In other words, there is a difference between a timing shift of cortisol output vs. the actual amount of cortisol being produced over 24 hours.

It’s typically not that the adrenals aren’t producing enough cortisol – it’s that the timing of cortisol release is being thrown off. (We’ll go over why this happens in the next section.)

Again, it is perfectly possible (and actually very common) to have low morning cortisol levels but normal or even HIGH total 24-hour output of cortisol.

Remember, the most common thing going on is not actually “low cortisol levels.” The most common abnormal cortisol finding is a flattened diurnal curve of cortisol – which simply means slightly lower morning cortisol levels and sometimes also slightly higher evening cortisol levels.

So what’s going on in the body that leads to low morning cortisol levels?

 

The 5 Primary Mechanisms of Low Morning Cortisol Levels

At this point, we now know the following 3 key points that completely disprove the adrenal fatigue theory:

  • Chronic stress does NOT generally lead to low cortisol levels.
  • Low cortisol levels are generally NOT associated with Burnout Syndrome or Stress-Related Exhaustion Disorder.
  • The vast majority of people with low morning cortisol levels typically do NOT actually have any problem with their adrenals being able to produce enough cortisol.

Now, even though we know that low cortisol levels (i.e. “adrenal fatigue”) is NOT actually the real cause of the symptoms associated with Burnout Syndrome and Stress-Related Exhaustion, some people are still skeptical and still want to believe in the adrenal fatigue theory, and say “well then why did my test show that I do have low morning cortisol levels?”

Indeed, the question now becomes…

If it’s not chronic stress wearing out your adrenals, then what are the real factors responsible for low morning cortisol levels?

We’re going to answer that definitively in this section and the following section, but first, there is something very important I need to remind you of…

Since cortisol levels/adrenal function are NOT the cause of burnout/exhaustion/chronic fatigue symptoms, trying to fix the symptoms fixing your adrenals/cortisol is utterly misguided.

Trying to fix your symptoms by “fixing” something that wasn’t actually causing your symptoms in the first place is not likely to result in much benefit. (This especially applies to things like “adrenal glandulars”, hydrocortisone prescriptions, and “adrenal support supplements.”)

In my experience, many of my fellow health practitioners who wish to believe in “adrenal fatigue” are angered by this assertion (even though the scientific evidence clearly supports it). But apart from them, generally speaking, most people I work with are alleviated to hear this and say something to the effect of “well that explains why I haven’t gotten very good results from trying to treat my adrenals.”

The reason adrenal fatigue focused treatments typically don’t result in profound benefits is simple: Because they’re trying to fix something that isn’t actually the cause of your problems.

By the way, the research also shows that giving patients with chronic fatigue syndrome hydrocortisone to raise their cortisol levels works no better than placebo in alleviating symptoms.[ii] That’s why this type of treatment was abandoned long ago by the vast majority of endocrinologists – because the science overwhelmingly doesn’t support its effectiveness.

Nevertheless, it’s always smart to normalize your hormones, and that can potentially help in recovery for some people. But my real goal here is simply to:

  1. Debunk the concept of “adrenal fatigue” so that people stop wasting their time and money trying to fix their fatigue and increase their energy levels by working on their adrenals or cortisol levels (i.e. taking adrenal support supplements, resting, eating special “adrenal diets”, or actually taking cortisol hormones in the form of adrenal glandulars or hydrocortisone medication.)
  2. Provide a scientifically accurate answer to the question of what is REALLY causing low morning cortisol levels (rather than the pseudoscientific answer of “adrenal burnout due to chronic stress.)

With that in mind, let’s talk about what really causes low morning cortisol levels, so that if you do want to know why your morning cortisol levels are low and how to fix it, you can do that.

In the next section, I will go over more than 20 factors known to cause (or be associated with) low morning cortisol levels. Virtually all of the factors that lower morning cortisol levels fall into the following 5 categories.

What most people who have low morning cortisol levels actually have is some combination of:

  1. A timing shift of their circadian rhythm of cortisol secretion, i.e. a “flattened diurnal curve” of cortisol. This means that they have less cortisol being produced in the morning and more being produced in the evening/night. This is by far the most common cause of low morning cortisol levels.
  2. Something impairing cortisol synthesis. This may be toxins interfering with enzymes involved in cortisol synthesis or micronutrient deficiencies in nutrients needed for synthesis of cortisol. (This is not yet backed by a large amount of evidence, and likely is only occurring in a minority of people.) Many common over-the-counter and prescription medications also are known to affect cortisol levels, such as many antidepressants, anti-anxiety drugs, blood pressure drugs, anti-inflammatory drugs, many pain drugs, etc.
  3. Simple measurement errors on the test. (Note: This is not a cause of your body having low cortisol levels, but a cause of why a test gives a false impression that your cortisol levels are abnormally low when they are actually normal.) There are a few simple and common errors when taking morning cortisol saliva tests that will the false impression of low morning cortisol levels. (All of these are common factors that will result in a lower cortisol level on your test. Importantly, these are simply measurement errors – not any actual inability of your adrenals to produce enough cortisol.)
    • Taking the test too late in the morning.
    • Taking the test after a poor night of sleep.
    • Taking the test on an off day from work instead of a work day.
  1. Psychological states and psychosocial factors can influence cortisol levels. Also, factors that relate to one’s perception of stress, sense of self, coping ability, and more can influence cortisol levels.
  2. A brain that is intentionally down-regulating cortisol levels (often as a result of inflammatory or immune processes). This means that the brain is intentionally sending signals to the adrenals to decrease cortisol output and it’s NOT because the adrenals are “burned out.”

With these five overarching mechanisms now in your mind, let’s now examine the specific factors shown by the research to cause low morning cortisol levels or be associated with a flattened diurnal cortisol curve…

However, if you truly do have a flattened diurnal cortisol curve (low morning levels and high evening levels), it’s certainly a good idea to understand what causes this hormonal abnormality and how to fix it.

There are numerous lifestyle factors (many of which are very common) that will cause low morning cortisol levels.

 

The 20 Real Causes of Low Morning Cortisol Levels

 

1.  Night Owl Chronotype (I.e. Staying Up Late)

Several studies have now shown that just being a night owl – no chronic stress, no symptoms, no burnout, no fatigue necessary – can cause morning cortisol levels that would get people diagnosed with “adrenal fatigue” (by a practitioner who believes in “adrenal fatigue.”)

Let me say this another way to illustrate how huge of a factor this is…

Let’s say you take a bunch of perfectly healthy people (i.e. no chronic stress, no burnout/fatigue/exhaustion) and organize them into two groups and then test their cortisol levels:

Group 1 – they go to sleep and wake up early (morning types)

Group 2 – they go to bed late and wake up late (night owls)

testing 2 groups for cortisol levels │ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comEven though all of these people in both groups are perfectly healthy and not stressed at all, the night owls will have dramatically lower morning cortisol levels compared with the morning types. Many of them could get diagnosed with “adrenal fatigue” based on their morning cortisol levels, even though they are perfectly healthy, not stressed and have no symptoms whatsoever.

You can see here from the following graph how one key study showed that night owls (evening types) who are perfectly healthy, non-stressed and non-symptomatic have the same exact low morning cortisol levels that are claimed to be caused by “adrenal burnout.[28]

The CAR and chronotype Is adrenal fatigue real│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.com

This isn’t “adrenal burnout” – it’s just the result of going to sleep late because you’re a night owl.

Numerous other studies have also confirmed this finding.[29],[30],[31],[32],[33],[34],[35]

Here’s a screenshot of the cortisol graph from one study that found almost HALF the morning cortisol levels in people who were night owls types compared to morning types.[36]

Dinural salivary cortisol pattern Is Adrenal fatigue real│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.com

Again, please note that just this one trait ALONE – being a night owl – is often enough to cause morning cortisol levels to test below the normal range for cortisol.

Just this one factor alone could get many of the people in this study diagnosed as having “adrenal fatigue” or “complete adrenal burnout” (by people who believe in adrenal fatigue) even though the people in this study are perfectly healthy and have no symptoms at all! They are just night owls, but don’t have burnout/exhaustion or fatigue.

 

2. Lack Of Morning Light Exposure (Due To Poor Circadian Rhythm Habits, And/Or Living In A Place With Long Months Of Low Sunlight/Overcast Skies)

Lack of morning light exposure │ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.com

As the last factor hinted at, factors that disturb the circadian rhythm have a huge impact on the circadian profile of cortisol. Since cortisol levels are in sync with the brain’s circadian clock, the levels of cortisol at different times of the day will be altered by any input that disrupts the circadian rhythm.

One other important factor that disrupts our circadian clock in our brain – chronically, for the majority of people in the modern world – is not enough bright light exposure during the daytime and especially the morning.[37],[38],[39],[40]

We spend our days indoors in dim light conditions, and most of us do not do the vitally important task of getting bright outdoor light in our eyes within the first hour of the day. Our circadian rhythm – and morning cortisol levels – depend on this in a big way.

For example, it is known that seasonal affective disorder (which is caused by low light exposure due to living in an overcast or low-light climate during the winter months) leads to profound depression, fatigue, apathy, and other symptoms. It also causes low cortisol levels in many SAD sufferers. And it is known that bright light therapy can both correct the cortisol disturbance and correct the symptoms of SAD.[41], [42]

 

3. Night Eating

Keeping with the same theme as the above two factors, one other factor known to disturb the circadian rhythm is eating late at night.

Sure enough, research has also shown that the simple habit of late night eating will cause lower morning cortisol levels.[43],[44]

 

4. Excess Body Fat (I.e. Being Overweight)

Research has shown that the more overweight someone is, the lower their morning levels of cortisol will be.[45]

Here is the graph from the key study on this topic:

how obesity affects cortisol is adrenal fatigue real│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.com

You can see clearly that being slightly overweight causes a slight lowering of morning cortisol, and being significantly overweight causes an even lower peak in morning cortisol levels.

 

5. Nutrient Deficiencies

Nutrient Deficiencies│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comA large amount of vitamins and nutrients are required for the mitochondria to carry out all its metabolic processes including the cortisol production pathway.

A particular study done on vitamin A deficient rats saw a marked decrease in in glucocorticoid production “even at the mildly deficient stage” (Juneja, Murthy, and Ganguly, 1966) whilst another saw cortisol production fall to a quarter of that of the control group when deficient in vitamin E.

Also note that these nutrient deficiencies are extremely common.

In addition, studies have found that consuming with multivitamin supplements can increase morning cortisol levels.[46]

Niacin derivatives, vitamin C, folic acid, pantothenic acid, biotin, calcium potassium, zinc and iron are all compounds that can potentially affect cortisol.

The evidence here is not overwhelmingly strong, but based on the existing evidence, it is certainly reasonable that a deficiency in various nutrients involved in cortisol synthesis may be a contributing factor for some people.

Recent evidence suggests that dietary intake of vitamins, in particular the B-vitamins including B6, B9 and B12 may have a number of positive effects on mood and stress. Given the effects of stress on a range of biological mechanisms including the endocrine system, it could be reasonably expected that multivitamin supplementation may also affect markers of these mechanisms such as diurnal cortisol secretion.

In the current double-blind placebo-controlled study 138 adults (aged 20 to 50 years) were administered a multivitamin containing B-vitamins versus placebo over a 16-week period. Salivary cortisol measurements were taken at waking, 15-min, 30-min and at bedtime, at baseline, 8-weeks and 16-weeks. Perceived Stress (PSS) was measured at baseline, 8-weeks and 16-weeks, while blood serum measures of B6, B12 and homocysteine (HCy) as well as red cell folate (B9) were also collected at these time points.

A significant interaction was found between treatment group and study visit for the Cortisol Awakening Response (CAR). Compared to placebo, at 16-weeks multivitamin supplementation was found to be associated with a near-significant trend towards an increased CAR. No significant differences in PSS were found between groups, with PSS increasing in both groups across the course of the study. Red cell folate was found to be significantly correlated with the CAR response at 16-weeks while HCy levels were not found to be associated with the CAR response, although HCy significantly correlated with waking cortisol levels at 8-weeks. A possible interpretation of the elevation in CAR associated with multivitamin supplementation is that this represents an adaptive response to everyday demands in healthy participants.

 

6. High Levels Of Depression (Major Depressive Disorder) And/Or Low Level Of Anxiety, And/Or High Perceived Suffering

Some studies show a link with higher levels of depression (major depressive disorder) and lower morning cortisol levels. (Though these findings are very mixed, and many studies show normal cortisol levels or even high cortisol levels. And it depends on the specific subtype of depression. In contrast, higher anxiety levels are associated with elevated morning cortisol levels.[47]

 

7. Rumination And Neuroticism

Rumination and neuroticism – both of which are contributing factors to depression – are also related to lower morning cortisol levels.[48],[49],[50],[51]

 

8. Helplessness/Hopelessness, Low Self-Esteem, And Low Perceived Coping Ability (Including Low Social Support And Low Psychosocial Resources)

Helplessness-hopelessness, low self-esteem, and low perceived coping ability (including low social support and low psychosocial resources)│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comAnother factor that can lead to lower morning cortisol levels is perceived suffering. If you perceive yourself as suffering – especially if you also perceive yourself to have little ability to do anything about it – you are more likely to have low morning cortisol levels.

“Self-reported higher anxiety levels positively correlated with steeper diurnal cortisol patterns, possibly showing body’s natural response to external stress. On the other hand, self-reported depressive symptoms at a severe level and higher suffering levels are related to abnormal stress reactivity seen as flatter diurnal cortisol patterns.”[52]

There are also several psychological traits and states that can contribute to low morning cortisol levels. Low self-esteem, high degrees of hopelessness and low perceived ability to cope with the demands on oneself are all linked with decreased morning cortisol levels.[53],[54]

In general, these correlations are small (in contrast to circadian rhythm and sleep disruptions, for example). Many studies that have examined personality traits and psychological states as they relate to cortisol levels find only small effects or no significant effects for most variables.

 

9. Cynicism

Cynicism (which speaks to personality traits and orientation to the world) is also linked with low morning cortisol levels.[55]

 

10. Medications That Affect Cortisol Levels (Many Antidepressants, Anti-Anxiety Drugs, Opioids, etc.)

Medications that affect cortisol levels (many antidepressants, anti-anxiety drugs, opioids, etc.)│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comSeveral different types of prescription and over-the-counter drugs can affect morning cortisol levels.[56]

One example is some types of antidepressants.

Here is a graph from one study that showed a lower peak in morning cortisol in people on antidepressants.[57]

The-impact of antidepressant use on mean salivary cortisol-Graph is adrenal fatigue real│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.com

This graph illustrates the morning cortisol awakening response in a group of people with stress-related exhaustion, that only differed based on whether they were on antidepressants or not.

Again, both groups had stress-related exhaustion, but the group on antidepressants had a significantly lower morning cortisol level.

Other medications that can affect (or can potentially affect cortisol levels) include:

  • Xanax[58]
  • Aspirin[59]
  • Tylenol/acetaminophen[60]
  • Gabapentin[61]
  • Opioids[62],[63],[64]
  • Some blood pressure lowering drugs[65]
  • Some anti-inflammatory and painkilling drugs, like Celebrex [66]

 

11. Recent Loss Of A Partner Or Social Isolation/Loneliness

Another factor that is associated with lower morning cortisol levels is loneliness and/or recent loss of a partner.[67],[68]

 

12. Ethnicity

Ethnicity│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comThis has not yet been extensively studied, but research does indicate that African Americans and Hispanics tend to have lower morning cortisol levels versus Caucasians.[69]

So if you are African American or Hispanic, this is a factor to consider in your morning cortisol level tests. It is totally normal for you to have lower cortisol levels in the morning relative to caucasians. This is also significant because established normal ranges for lab tests may be predominately based on cortisol levels in Caucasians (since they represent a much higher proportion of the population.)

 

13. Low Physical Activity Levels/Being More Sedentary

Several studies have shown that lower physical activity levels during the day can cause a lower morning peak in cortisol levels.[70]

Here is one study that looked at people with major depression to examine how their physical activity habits related to their cortisol patterns.

Estimated salivary cortisol curves by different levels graph│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.com

Higher physical activity led to a more pronounced rise (awakening response) and fall of daily cortisol levels (which is a good thing). On the other hand, being more sedentary was associated with a flatter diurnal cortisol curve (lower morning cortisol and higher evening cortisol).

 

14. Anticipation Of Low Demands In The Upcoming Day

Anticipation of low demands in the upcoming day. Simply having a day off work (or not having a job) instead of working│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comSimply having a day off work (or not having a job) instead of working.

Research has even shown that morning cortisol awakening response can be high one day and low the next, as a simple function of whether or not someone has work that day or it’s a weekend.

Specifically, having work (and thus a greater anticipated demand of the day) will lead to a higher cortisol peak, and having a day off work leads to a lower cortisol peak.[71]

Cortisol Awakening Response CAR at the work Graph│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comAs you can see from the above graph, simply having a day off dramatically lowered morning cortisol awakening response in all groups. In fact, levels from workday to non-workday vary by close to 50% in the same person! I.e. Morning cortisol levels on work days can be close to 50% higher than non-workdays.

Importantly, this change occurred from one day to the next in the same individuals, and thus contradicts the notion that morning cortisol levels are an accurate biomarker of one’s adrenal function. Levels vary dramatically from one day to the next just by one single variable whether you have work that day or not (or other variables like how well you slept the night prior to the test).

(Side note: This also represents a significant confounding variable in cortisol testing, because people doing at-home tests take measurements on non-work days, they will measure with significantly lower cortisol than on work days. Also, for people who don’t work at all, they may test dramatically differently compared to if they had a job. This factor is never controlled for on cortisol tests done by clinicians. Ideally, there should be separate “normal ranges” of morning cortisol levels for working people vs. non-working people because normal ranges for these groups are very different. And people should be instructed to do cortisol tests at home only on work days and not non-work days.)

Key point: Lower perceived demands of the day – from either not having a job or simply having a day off from work that day – leads to dramatically lower morning cortisol levels. This can occur from one day to the next and shows that cortisol levels are not a stable reflection of adrenal function, but are dynamic in responding the environment from one day to the next.

 

15. Lower Socioeconomic Status

Lower socioeconomic status│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comLower vs. higher socioeconomic status is another factor that can contribute to lower morning cortisol levels.[72] The exact reasons why this occurs are not fully understood, but I suspect it may relate to the previous factor about perceived stress/hopelessness and low perceived ability to cope with the demands on oneself.

It may also relate to the previous factor, since rates of unemployment are likely higher in low socioeconomic groups, and not having a job (low anticipation of demands in the upcoming work day) is linked with lower morning cortisol levels.

 

16. Psychological Trauma, PTSD, Or Childhood Adversity

Psychological trauma, PTSD, or childhood adversity│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comOne of the factors that has been consistently linked with lower morning cortisol levels is post-traumatic stress disorder (PTSD).[73]

Both childhood trauma and PTSD are associated with lower morning cortisol levels and a flatter diurnal cortisol curve (lower morning cortisol and higher evening cortisol). Having a childhood with lots of adversity, and even having a childhood caregiver with low self-esteem are all also associated with low morning cortisol levels in adulthood.

More than reflecting the current stress load on the body or the adrenals’ ability to produce enough cortisol, this likely has to do with how early life stress or past-trauma can re-wire the stress response systems of the body. Psychological trauma can have a lasting impact on HPA axis function and leave its imprint by essentially re-wiring the way the brain regulates the stress response, and this is reflected in cortisol levels.

 

17. Genetic Influences/Inheritance

Genetic Influences Inheritance │ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comThere is also a sizable body of evidence in both animals and humans showing that different groups of people have different baseline cortisol level that they are born with – not as a result of anything they’ve done or not done.[74],[75],[76]

It’s also been shown that low baseline cortisol levels can be passed on from one generation to the next. I.e. If your mother had lower baseline cortisol levels, you may have it as well, just due to genetic influences.

 

18. Toxins

toxins│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comWhile still somewhat speculative in showing a direct link in humans with low cortisol levels, there is research in animals and humans showing that several different types of chemicals in the environment have been shown to interfere with enzymes involved in cortisol synthesis.

Given that we know we are being exposed to these chemicals – and tests have shown these chemicals present in significant quantities in most humans in the Western world – it is reasonable to believe that exposure to these compounds can at the very least be a small contributor to why someone may have lower cortisol levels.

Importantly, I want to distinguish between the concept of “chronic stress wearing out the adrenal glands” vs. chemicals interfering with specific enzymes involved in cortisol production. To put it simply: Running out of gas is very different from a traffic jam on the freeway.

In this case, we’re talking about the adrenals having a “traffic jam” of sorts, with regard to the biochemical processes involved in cortisol synthesis.

The story however, is not as simple as simply saying “exposure to these compounds decreases cortisol production”, as distinctions within each study have to be made between low and high doses, acute and long term exposure, whether the individual affected is male or female and whether the measurement of cortisol is a baseline reading or one from stress provocation.

The picture is further muddled when we see elevated levels of cortisol in some studies and, within others, a drastic reduction. It cannot be said whether all of these toxins produce low cortisol levels in all individuals at all levels of exposure but it is clear that serious hormonal disruption is occurring in many circumstances, often affecting cortisol production.

Here are some of the relevant things to know about toxins and cortisol:

  • Particular toxins such as glyphosate (Roundup) and other pesticides, fungicides, BPA found in plastics and heavy metals have been shown to interfere with cortisol levels in the blood. [77],[78],[79],[80],[81]
  • One study showed that exposure to arsenic decreased activity of the enzyme, 3β-Hydroxysteroid dehydrogenase which is a key mitochondrial enzyme used in the first step of the pathway converting cholesterol into cortisol.[82]
  • Another study observed the inhibiting effect of azole fungicides upon an enzyme called steroid 21-hydroxylase (CYP21).[83] This enzyme is found within specific cortisol producing cells in the adrenal glands and its functioning is key to the normal production of cortisol and, as you can guess, presence of the azole fungicides could disrupt production and lead to hypocortisolemia.
  • People who live in very agricultural or industrial parts of the country may be exposed to unhealthy levels of these azole fungicides and pesticides like glyphosate.[84]

Exposure to BPA, pesticide residues, and heavy metals is ubiquitous. And again, it is known that significant amounts of these compounds in the body can hinder the enzymes needed for cortisol synthesis (among many other effects.)

 

19. HPA Axis Hypoactivity (Low Cortisol Levels) Is A CONSEQUENCE Of Oxidative/Nitrosative Damage And Over-Activation Of Immune/Inflammatory Pathways

Chronic inflammation will eventually lead to suppression of cortisol levels. This is not due to the body’s adrenal glands wearing out and being unable to produce enough cortisol, but rather is due to the body intelligently trying to facilitate inflammatory processes against inflammatory insults.

Chronic oxidative stress (from junk food, mold, toxin exposure in food/water/air/personal care products, etc.) can also cause the body to intentionally suppress cortisol levels. And immune insults – like chronic infections, and poor immune function – can also lead to the body intentionally suppressing cortisol levels.

Combinations of chronic inflammation, oxidative damage, and immune activation (e.g. junk food, mold, infections, toxin exposure) are likely especially effective at making the body decrease cortisol output.

Cortisol is anti-inflammatory and suppresses immune function. So basically these things oppose each other. If the body is trying to prioritize increasing inflammatory and immune responses, it will tend to decrease cortisol levels.

In people with Chronic Fatigue Syndrome specifically, research has shown that when people have low cortisol levels, it is likely just a consequence of increased inflammation and immune activation.[85]

One important study describes this phenomenon as an important way the body adapts. I.e. The body intentionally lowers cortisol as an adaptive and intelligent response to support proper immune system and inflammatory system functions:

“While the terms adrenal fatigue/exhaustion may serve to point out reduced adrenal production of cortisol and DHEA, the adaptive changes are most often initiated within and propagated by the hypothalamus and pituitary. In fact, some researchers believe that the adaptation by the HPA axis is a protective device to ensure long-term survival by preventing chronically high cortisol levels from suppressing immune function and increasing catabolic pathways.[86]

(Knowing this, it’s important to understand that the goal in such a scenario is not simply to take cortisol boosting compounds or to treat the adrenal glands, but instead to address the factors causing chronic inflammation and immune overactivation.)

 

 20. Poor sleep (or lack of sleep)

│ The Hidden Truth About What Causes Low Cortisol Levels (The Real Causes of “Adrenal Fatigue”) – Plus Secrets of Healing “Adrenal Fatigue”, and How To Treat “Adrenal Fatigue” The Right Way │ low cortisol levels │ Adrenal fatigue treatment │ what causes adrenal fatigue │How to cure adrenal fatigue, theenergyblueprint.comThis, along with the two circadian rhythm related factors, are the absolute biggest causes for the vast majority of people who have low morning cortisol levels.

Several studies have shown that simply sleeping poorly will cause a lower peak in morning cortisol.[87],[88],[89]

This may be from not having enough hours of sleep or from sleep disorders or sleep apnea, or simply from poor circadian rhythm and sleep hygiene habits that result in poor “sleep efficiency.”

Importantly, it’s not just the number of hours you sleep, but also the quality of your sleep (i.e. sleep efficiency) that affects Hypothalamic-Pituitary-Adrenal function and cortisol levels.[90]

Sleep efficiency is basically how restful and regenerative each hour of sleep is. I.e. It’s possible to sleep 8 hours with high sleep efficiency or sleep 8 hours with poor sleep efficiency – and this makes a huge difference to your health and hormonal function.

There is no need for chronic stress over months/years to exhaust the adrenals – a few nights of poor sleep will cause the same exact cortisol abnormality that some people think is “adrenal fatigue.”

Moreover, in case you would still be inclined to try to explain things through the lens of “adrenal fatigue” theory and say that the poor sleep is exhausting the adrenals, it’s worthwhile to note that the research has actually shown that even a single night of poor sleep will cause low morning cortisol, and that simply correcting the sleep can immediately resolve the cortisol pattern back to normal, within just days.[91] In other words, these changes reflect a dynamic daily shifting of cortisol output in response to what’s going on day-to-day, and the cortisol levels are NOT a stable and accurate diagnostic of the stage of “adrenal burnout.” So there is no need to invoke any theories about the adrenals getting “fatigued” in order to explain low morning cortisol levels – it can simply be an acute response to poor sleep or disrupted circadian rhythm (or having a day off work, or many of the other factors listed in this article).

For example, day-to-day sleep variations and something as simple as prior day napping can have a huge impact on cortisol levels: “Both daily variations in sleep behaviors and ongoing sleep disturbance and fatigue are associated with a disrupted cortisol rhythm. In contrast, prior-day napping is associated with a more robust cortisol rhythm.”[92]

In other words, morning cortisol levels change from one day to the next according to how much sleep you get. Sleep more and take a nap in the afternoon and you can sometimes go from abnormal cortisol levels one day back up to normal the next day.

Another study in people with depression supports this view as well. They found that it is only those people who have trouble sleeping that have low morning cortisol – i.e. the people with depression who don’t have sleep problems have normal cortisol levels.[93] Again, this suggests that it is the sleep issues that are causing the cortisol abnormalities. (I.e. Contrary to the explanation you’d hear from advocates of adrenal fatigue, this study makes it clear that the low morning cortisol isn’t the “cause” of the symptom of depression – the low cortisol levels are simply an epiphenomenon that occurs in those depressed people who don’t sleep well, as a SYMPTOM of the poor sleep.)

One study on people with Burnout Syndrome went so far as to say:

“The data supports the notion that sleep impairments are causative and maintaining factors for this condition.”[94]

Another study in chronic fatigue syndrome concluded:

“Neuroendocrine abnormalities (i.e. low morning cortisol) reported to be characteristic of chronic fatigue syndrome may be merely the consequence of disrupted sleep and social routine.”[95]

Cortisol levels are NOT an accurate reflection of the degree of chronic stress a person is under (as we’ve seen in the previous sections), but they ARE a pretty good reflection of whether or not a person is getting enough deep restful sleep. (Not because sleep “burns out the adrenal glands”, but because it disrupts the timing of cortisol release during the day.)

The simple fact is that this one factor – poor sleep – is, by itself, enough to cause low morning cortisol levels that could get you diagnosed with “adrenal fatigue.”

Given how common sleep problems are in people with Burnout, Stress-Related Exhaustion, and Chronic Fatigue Syndrome, it’s actually a wonder that most people with these conditions still don’t have low morning cortisol levels.

Along with being a night owl chronotype, these two factors alone – even without all the other factors listed above – are easily enough to cause low enough morning cortisol levels to get a person diagnosed with “adrenal fatigue.”

But contrary to the views of “adrenal fatigue” proponents, the solution to this isn’t to take adrenal support formulas or take cortisol (from hydrocortisone or adrenal glandulars) – it’s to correct the circadian rhythm and sleep patterns.

Now that you know the major causes of low morning cortisol levels (and a flattened diurnal cortisol curve), let’s talk about how to FIX this issue…

 

How To Fix Your Low Cortisol Levels

Now that we’ve covered the main causes of low morning cortisol levels, let’s talk about how to fix it. In essence, this comes down to simply correcting the factors causing the low cortisol levels in the first place. In some of these cases this is very simple and quick, and in others, much more complex.

 

Step 1 – First Make Sure You Did The Test Correctly And That You Truly Do Have Low Cortisol Levels

First, make sure that you actually do have low morning cortisol levels, and it was not a mistake in testing. As you’ve seen, there are several different testing errors that can get someone falsely diagnosed with low morning cortisol levels.

  1. If you did a one-time measurement of cortisol (as some tests do), this is not a valid diagnostic measure. Valid cortisol measurement requires you to take 4 cortisol measurements over the course of the first few hours of the morning.
  2. If you did your previous cortisol test on a weekend (or non-work day), do the test again on a work day. You may not have low morning cortisol at all, but you may simply have tested it on an off day from work, and thus had much lower cortisol levels than is normal for you on work days.
  3. If you got a poor night of sleep the night before testing your cortisol levels, take another test after a good night of sleep.
  4. If you did not take your first cortisol measurement within the first 30 minutes of awakening, your results may not be valid. Do the test again, and make sure to get the time of saliva samples absolutely correct. Waiting too long after awakening to take the saliva samples can result in a false diagnosis of low cortisol levels when your cortisol levels are actually normal.

(Note: If you have extremely low cortisol levels at all times of the day – not just slightly low cortisol levels in the morning – and you have symptoms like loss of appetite, loss of body weight, dark spots developing on your skin, etc., please see a physician and get checked out for Addison’s disease).

Assuming your test is valid and you truly do have low morning cortisol levels, then go on to Step #2 on how to fix the factors that cause low morning cortisol levels.

 

Step 2 – Fix The Factors That Cause Low Morning Cortisol Levels

Now, let’s assume that there are no errors in testing, and you truly do have low morning cortisol levels and/or a flattened diurnal cortisol curve (low morning cortisol and higher evening cortisol).

Remember, it is almost always the case that a person doesn’t’ have any actual inability of their adrenals to pump out enough cortisol. So the goal is not to heal the adrenals, with the idea that would fix your cortisol levels. The goal here is two-fold: 1. To increase morning cortisol release, and 2. To decrease evening/night cortisol levels.

Here are the fundamental steps to correcting your low morning cortisol levels and/or lowering elevated evening/night cortisol levels:

 

  1. Optimize Your Circadian Rhythm. Here are some of the strategies I teach in The Energy Blueprint program to help you do this:
    • Get bright light within the first 30 minutes after waking
    • Shift bedtime and wake time earlier to shift away from a night owl rhythm
    • Block artificial light at night with blue blocking technology (and ideally, blue/green blocking glasses)
    • Consistently go to bed and wake up at the same time
    • Consume your last bite of food no later than 2 hours before you sleep (and ideally earlier)
    • Get more bright outdoor light during the day
  2. Decrease inflammation and oxidative damage at the cellular level. This is obviously a complex one that really involves deep and systematic nutrition and lifestyle changes, and thus can’t be summarized in a few sentences. But the basic gist of this is: Consume anti-inflammatory foods, get rid of inflammatory foods, address gut permeability, lower your exposure to heavy metals and inflammatory toxins in the food/water/air supply and your personal care products, and follow the lifestyle strategies outlined above around circadian rhythm, sleep, nutrition, and other lifestyle and psychological factors. (If you want a comprehensive and step-by-step plan to do all of this in the fastest and most powerful way possible, get The Energy Blueprint 60-day program.)
  3. If you are overweight, adopt systematic nutrition and lifestyle changes to lose excess body fat.
    • Talk to your doctor about the possibility of weaning off any medications that affect HPA axis function. This includes (but is not limited to) many antidepressants, Xanax, Opioids, many anti-inflammatories, many painkillers, and blood pressure lowering medications, among others.
  4. Address past psychological/emotional trauma. This is a complex one and there are many different approaches to doing this. A few recommendations and possible paths:
    • Do psychotherapy (e.g. CBT, hypnotherapy, or other forms of talk therapy) or alternative psychotherapeutic methods (e.g. EFT, trauma-release movement therapies, etc.)
    • Start a dedicated daily meditation or mindfulness practice
    • Volunteer for MAPS to be a part of one their studies using MDMA- or psilocybin-assisted psychotherapy. The results from the studies on people with PTSD using these methods have been incredible.
    • Consider working one-on-one with a trauma release expert. (I highly recommend Niki Gratrix). I have heard amazing feedback from members of the Energy Blueprint program about working with Niki one-on-one.
  5. If you work a desk job or don’t do exercise (and you’re mostly sedentary), get MOVING! Start with a foundation of gentle movement (e.g. walking, yoga, qigong, pilates, dance) and add in higher intensity exercise (interval training, endurance exercise, and/or weight training) multiple times a week in accordance with your fitness levels.
  6. Have an evening meditation, mindfulness, qi gong, or yoga practice. [96],[97],[98] There are dozens of health benefits associated with these practices, and lowering cortisol levels is just one such benefit.
  7. Make love or hug and kiss your partner (if you have one) in the evening. Oxytocin helps decrease cortisol and prevents excessive increases in cortisol from mild stressors.[99] And oxytocin is released in our bodies in response to physical touch, affection, and sex.
  8. Get out in nature during the afternoon/evening. Nature – or “forest bathing” as much of the research refers to it – has a profound effect on numerous systems of your body, including cortisol levels. It can be very effective in lowering cortisol levels in the evening. [100]
  9. Address potential toxins in your body like heavy metals, BPA, pesticides, etc. that are known to interfere with cortisol levels. This includes:
    • Good nutrition habits
    • Using non-toxic personal care
    • Using non-toxic kitchen products
    • Getting a high-end water filter to drink truly pure water
    • Using nutrition and lifestyle strategies to support liver health
    • Using more aggressive detox protocols including sauna and various supplements designed to support detoxification
  10. Have a distinct difference in your day as far as time to work and time to relax.
    • It is natural for cortisol to rise strongly in the morning after awakening and to be low in the evening and night. You want to facilitate and amplify this natural rise and fall through your lifestyle habits. Here’s what I mean:
      1. Get up and get moving – physically and psychologically. Get bright outdoor light, physically move your body, and get your brain working. Plan your day and get mentally prepared for tackling the tasks of the day. All of these will help stimulate a proper morning cortisol release.
      2. In the last few hours of the day, wind down and do things that are relaxing and don’t involve the same level of hustle and stress as the morning and afternoon.
  11. Correct your sleep. This is another complex one, but is perhaps the most common cause of low morning cortisol levels for most people. Thus it is also the single most powerful way to correct morning cortisol levels – sometimes within a matter of a few days or a couple weeks. If you want more details on how to start doing this, Module 1 of my Energy Blueprint program is all about this subject and gives 27 strategies to optimize circadian rhythm and sleep. (Many people report that this dramatically deepens their sleep and increases their energy within the first two weeks on the program.) Here are some powerful strategies to get you started:
    • Follow the circadian rhythm strategies outlined above. This is CRITICAL for sleep quality.
    • Follow the pre-bed ritual recommendations outlined above, and incorporate some combination of meditation/nature/yoga/journaling/sex in your evenings.
    • Sleep in complete darkness (use blackout shades ideally, or an eye mask if blackout shades are not doable.)
    • Sleep on a high-quality mattress proven to enhance sleep quality (see my podcast here).
    • Get electronic devices out of your room, and/or make sure you’re not exposed to blue light or significant electromagnetic fields (which also suppress melatonin levels.)
    • If you normally wake up extremely unrefreshed (and/or your partner tells you that you snore), get checked for sleep apnea. This and other sleep disorders are extremely common among people with Chronic Fatigue Syndrome (over 50% of people with CFS have a sleep disorder), and they are common in people with Burnout Syndrome as well. Getting diagnosed and treated for sleep apnea (e.g. a CPAP machine) can be life-changing for some people.
    • Have a relaxing pre-bed ritual for 1-2 hours before bed. This should be your time to allow your brain to turn off.
      • Stop working, stop trying to solve problems, stop ruminating, and release any stress/negativity/tension of the day. Actively do things during this time period that supports this process.
      • Consciously engage in positive emotional states – e.g. do gratitude journaling, laugh with a friend, watch stand up comedy or videos you find funny.
      • Do a physical release (e.g. yoga/stretching/sex), and do a mental release (e.g. meditation/mindfulness).
      • Do something relaxing and enjoyable like reading a book or watching a relaxing and fun movie or watch stand-up comedy or make love. Turn off your brain and body, and help everything go into relaxation and regeneration mode.

 

Final Words

These are the REAL reasons why people typically have low morning cortisol levels. It’s not due to chronic stress wearing out your adrenals and rendering them incapable of producing enough cortisol. It’s one or more of these factors that have shifted your cortisol rhythms and/or caused your HPA axis to regulate cortisol levels differently (i.e. less cortisol in the morning and more in the evening).

Working on your circadian rhythm and sleep habits, losing body fat (if you’re overweight), weaning off medications that disrupt HPA axis function, physical activity, correcting chronic inflammation, working on psychological health, good nutrition habits, and a powerfully relaxing and regenerative pre-bed ritual will correct low morning cortisol levels (and high evening cortisol levels) for the vast majority of people with low morning cortisol levels, often times within a few weeks.

I hope that this information will shift the paradigm around the common thinking about fatigue being caused by “adrenal fatigue” (due to chronic stress wearing out the adrenals), and that we can begin to focus our energy on fixing our symptoms by addressing real root causes.

 

Article Summary

The evidence does not support the “adrenal fatigue” theory.

  1. Chronic stress is NOT reliably associated with low cortisol levels (thus disproving the “adrenal fatigue” theory).
    • The evidence does not support the claim that there is a general pattern where chronic stress (or chronic disease) leads to “adrenal fatigue” or low cortisol levels.
  2. Stress-Related Exhaustion and Burnout Syndrome have no clear connection to abnormal cortisol levels or adrenal function. These conditions/symptoms are clearly NOT caused low cortisol levels.
    • So remember, fixing your cortisol levels won’t necessarily fix your fatigue/burnout symptoms.
  3. So what causes low cortisol levels? Lower morning cortisol levels are typically the result of some combination of the 20 lifestyle and environment factors mentioned above. The biggest factors in lower morning cortisol levels (i.e. the most common causes of low morning cortisol levels) are circadian rhythm disruption, being a night owl, and poor sleep. 
  4. Secondary to that, the most common causes of lower morning cortisol levels for most people are likely to be one or more of the following factors:
    • Chronic inflammation or immune activation
    • Medications which interfere with cortisol (e.g. many antidepressants, Xanax, Opioids, anti-inflammatories, painkillers, and blood pressure lowering medications, etc.)
    • Lack of physical activity
    • Excess body fat
    • Not being employed (or taking the cortisol test on a day off from work)
    • Psychosocial factors: rumination, neuroticism, depression, suffering, social isolation, low self-esteem, low social support, and/or low perceived coping ability
    • Genetic influences (e.g. ethnicity, family ancestry with 21-hydroxylase deficiency, or parents with history of trauma, etc.)
    • Past history of trauma or childhood adversity
  5. You can fix your morning cortisol levels by using the above list of strategies. I suggest focusing your efforts on the following strategies:
      • Optimize circadian rhythm
      • Optimize sleep habits
      • Decrease inflammation and oxidative stress at the cellular level
      • Movement/physical activity
      • Meditation/mindfulness/yoga practices in the evening
      • Optimize light exposure habits
      • Check with your doctor about any medications you may be using that affect cortisol levels
      • If you have a history of psychological abuse/trauma, address that using the above strategies
      • Adopt strategies to amplify the normal rise and fall of cortisol at the appropriate time of day
      • Pre-bed ritual including strategies to directly calm the brain and nervous system using the above recommendations

By using the above strategies to fix your cortisol levels – i.e. by actually understanding the true causes of low morning cortisol levels and addressing them appropriately – you can potentially fix your cortisol levels in a matter of a few weeks (as opposed to the 6-12 months often claimed by “adrenal fatigue” proponents.)

 

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How To Overcome Anxiety and Stress, And Increase Your Energy with Christa Orecchio

how to overcome anxiety and stress, and increase your energy with Christa Orecchio
Got stress, anxiety, and fatigue? Then you will be interested to hear Christa Orecchio’s approach to re-wiring your nervous system with her 6 pillars to overcome stress, anxiety, and get more energy.

In this episode, I have with me, Christa Orecchio, who is a clinical and holistic nutritionist and founder of the Whole Journey. She helps people heal from the root cause, using food as their medicine and a mind body spirit approach to health.

In this podcast, Christa will cover

  • What it means to live off stress hormones
  • Christa’s 6 pillars of health
  • Why do most people stay in stress?
  • Why breathing is essential to overcome stress
  • Why Christa doesn’t like the low-carb approach and believes that adequate amounts of carbs are essential for your health
  • How your childhood can affect your health (and how to heal from emotional trauma)
  • What foods can I eat to overcome stress, and anxiety, and fatigue?
  • Why Christa recommends frequent meals
  • Why nutrient ratios matter (and how to track it)
  • Christa’s new “Adrenal ReCode” Program (You can find more information about that HERE)

 

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How To Overcome Anxiety and Stress, And Increase Your Energy with Christa Orecchio – Transcript

Ari Whitten: Everyone. Welcome back to the Energy Blueprint Podcast. I’m your host, Ari Whitten, and today I have with me Christa Orecchio, who is a clinical and holistic nutritionist and founder of the Whole Journey. She helps people heal from the root cause, using food as their medicine and a mind body spirit approach to health.

Christa is a bestselling author, TV show host and is super passionate about helping you heal your adrenals, thyroid and nervous system in the most holistic way possible. So welcome to the show, Christa.

Christa Orecchio: Thank you for having me, Ari. I am super excited to be here.

Ari Whitten: Yeah, likewise. And on a personal note, I will say that it was such a pleasure, getting together with you for lunch, I believe it was last week or the week before and getting to talk so much geeky stuff with you around nutrition and health and it was just an absolute pleasure.

Christa Orecchio: The pleasure was mine. I mean, really, it’s funny. We’ve lived so close to each other for so long. Just got to know each other.

Ari Whitten: Yeah, totally.

Christa Orecchio: So that will be the first of many lunches we have.

 

What it means to live off stress hormone

Ari Whitten: I hope so. So, I know that, you know, one of the things we talked about is you have a new program that you’ve been developing called “Adrenal Recode” and it really revolves around kind of the nervous system’s role in an illness and symptoms and stress hormones. And that one of the things that you say is that the majority of us are living off of stress hormones and we’re not aware of it.

So first of all, how do we know if that applies to us as individuals? And what exactly do you mean by living off of stress hormones?

Christa Orecchio: So, well you know that if that applies to you as an individual, if you’ve had longstanding problems with anxiety, that’s really your telltale sign. If you’ve had longstanding problems with anxiety or insomnia. If you wake up like consistently between one and 4:00 AM, almost like not able to go back to sleep, ready to start the day.

Or when you do wake up in the morning, it’s earlier, like before the alarm you wake up with your heart pounding. These are all signs, but you know, really kind of living in a state of fear, living in a state of overwhelm, that inability to relax and sometimes it’s that alternating anxiety and depression or it’s like at the same time, you know, you’re tired and wired at the same time, but you just, you can’t let go even though you’re just completely exhausted. You have no energy whatsoever, but yet you kind of feel that fried feeling.

Ari Whitten: Gotcha. So, so, so that’s how we know if it applies to us, what does it mean to be living off of stress hormones? Like what hormones are you talking about in particular and why are we in your, in your words, living off of them?

Christa Orecchio: Yeah, so we’re living in a state of stress, so it really comes down to within our central nervous system, within the autonomic nervous system, when we have the sympathetic nervous system and we have the parasympathetic and sympathetic nervous system, is that fight, flight or freeze. You don’t hear freeze a lot. But that’s what a lot of us do under stress. And when we’re in that state, we need that nervous system. We need a balance, a really healthy balance of both in order to thrive, but what happens is we’re constantly clicking on this sympathetic nervous system unnecessarily so we’re completely overreacting to things as if we’re in danger and we get stuck in this way of responding and reacting and we don’t live in our parasympathetic nervous systems anymore. I know that’s where rest, digest and heal. That’s where we do all of our digesting. That’s when the body can recover and that’s when the body can heal and we should spend the majority of our time, when we’re not in danger in the parasympathetic nervous system.

So, it could be, you know, life can be a lot sometimes. Right, Ari? It’s like modern life and so it could be the stresses we’re under, but a lot of times it’s things that happened to us that forced us into the sympathetic nervous system for a long period of time. So that could be something like childhood trauma. That could be. You could have gone through a divorce or major breakups or having recently had a baby, you know, having a child.

Just the act of going through pregnancy and especially if it’s a traumatic birth and becoming a new mother, sometimes if then you start to add multiple kids to that and just there’s so much to balance, so it doesn’t necessarily have to mean you’ve gone through a trauma. Or like we were talking at lunch, entrepreneurship can do this too, right?

It’s like you’re in the middle of a launch and it’s just too much to do and not enough time to do it. That type of thing, and so what happens is we lose our ability to toggle between these two nervous systems in a healthy way and we get locked in the sympathetic nervous system.

So now we’re constantly releasing adrenaline and then we move into releasing cortisol and what happens is our cells lose their ability to be sensitized to insulin. So now energy can’t get delivered. Glucose can’t get delivered into the cell. And now your thyroid can’t make her burn energy. So, you can’t have an adrenal problem without having a thyroid problem and a nervous system problem and a brain problem because really, they just know all four of them work so intimately together and it’s about healing these systems.

And so, we’re stuck in this habit. We’re stuck in this pattern and you know, I spent a decade in private practice, and I have this one client story that was like a life defining moment for me where I really got this.

And I used to run a ton of neurotransmitter panels where I’m looking at the metabolites of the neurotransmitters, the chemical messengers in the brain. And I’m looking at those in urine to see, okay, what’s going on with this person system with their inhibitory neurotransmitters are the ones that make us feel calm and help us manage stress and help us sleep.

Versus the excitatory ones that, you know, we get anxiety, we get inflammation, we start to get brain trouble. And I looked at this woman’s panel and it looked like she was in like utter crisis. And I had known her for four months at that point and we weren’t getting progress.

But her life was fine, she was happy in her life and I just say, what happened, you know, what, what’s going on? Is there something you didn’t share with me?

And she had a lot of childhood trauma and sexual abuse that she had never shared with anyone. And it was like, that’s an extreme example, but it was, to me it was like, wow, people are getting locked into this state and they’re not getting out of it.

So, you have to get out of that state in a physical way. And then also in a, in an emotional way.

Ari Whitten: I want to talk about the concept of “Adrenal Fatigue” briefly. This is something you and I chatted a bit about at lunch. You know, that I’m not a proponent of the “Adrenal Fatigue” theory and sort of the traditional model of like the three phases of Adrenal, like chronic stress wears out, uh, the adrenals and, and that, you know, sort of results in low cortisol which results in these symptoms of fatigue and insomnia and depression and anxiety and a variety of others.

I don’t think the evidence supports that, but I know that your take on this on adrenal health and how it ties into neurotransmitter health, central nervous system, health, thyroid health, all these other layers to the story that you’re talking about quite a bit more complex than just saying chronic stress wears out the adrenals. Then you get low cortisol that causes your problems.

And also, it seems to me, and please correct me if I’m wrong, it seems to me that you are not really saying that most people have low cortisol necessarily, but in some cases, people have high cortisol. Is that correct?

Christa Orecchio: Yeah. And I agree with you that the term “Adrenal Fatigue” is like a gross over simplification of what’s happening. And the adrenals role in this is, it’s just a, it’s a circadian rhythm problem, right?

Like we secrete certain amount of cortisol to get us up and got us going for the day and lower cortisol so that we can sleep. And so adrenal problems were being stressed too much. You start to go wild fluctuations because. Right? I mean, if you have high cortisol, then your blood sugar, you can’t regulate your blood sugar and so the two of these are working in tandem and so yeah, it’s a circadian rhythm issue and it’s just a regulation. You just. You can’t secrete the right amount of cortisol at the right time basically.

 

Why most people stay in stress mode

Ari Whitten: Got It. So, we’re living off stress hormones. Many of us have these wild fluctuations of stress hormones. We have an inability to toggle between, stressed out, stress response, sympathetic nervous system, getting back into rest, digest, heal, parasympathetic mode.

How did we get this way? What’s going on in the modern world that made this situation so common?

Christa Orecchio: Yeah. Well, outside of life being a lot like we just talked about from parenting to single parenting to overwork, to just general stress. I mean I definitely want to throw technology into the mix and that deserves a little bit of the blame, right? They say that we light up dopamine in our brain every time. Oh, I’ve got five text or 20[flag] messages or emails, right? You, you actually light up dopamine in the brain which is part and parcel, like constantly activating that reward center and dopamine can get us in there like we’re all really overstimulated. And we become addicted to that feeling of being overstimulated.

Just ask the teenager when you take away their phone for a day, right? So, so that happens. But also, a lot of us, especially if we’re busy, we what do we do? Like we go for quick fixes, so we over rely on coffee and we want to feel… we want to calm down at night, so we over rely on wine or sugar and those types of things and we let exercise fall to the wayside. So there’s things that keep us in balance and can normally moderate these hormones like we don’t anymore because we are convenience oriented and we let our diets slip and then all of a sudden now you have this compromised body because whenever you’re in that parasympathetic nervous system, your body’s job is just to keep you alive and keep you out of danger.

Like you are not going to be digesting your food. Your blood is going to be shunted away from the digestive system to the limbs, right? You have to be on high alert, so whatever it is that you’re eating is gonna. Sit like a rock in your stomach. You’re not going to digest it, even if it’s healthy food and nine times out of 10 when you’re in this stressful state, it’s probably not going to be healthy food.

And so, there’s this just like a culmination of the perfect storm that gets us this way and then it’s like a whirlpool and then we’re stuck in it and we’re living in it and now people say, oh yeah, they think that’s who they are. That’s their new normal. I get hangry, you know, like if I, if I don’t have enough food, you know, so they carry food with them or I’m a night owl now, right? Or I’m a, I have a short fuse, don’t piss me off.

And people think that’s who they are and that’s going to be. They’re normal and they’re just going to live forever. But that was so transformative in my life when I write, because you ended up liking yourself better. You have a completely different experience of life, you have different relationships, you do different things with your time and so I really want to drive home the point that this is in a distress, adaptive state of your biochemistry, but it’s not who you are.

And physiologically, you know, when we’re stuck in this state for too long, we can’t convert our food into fuel, and we have no resilience to stress. So, there’s so many people out there that feel like not one more thing. One more thing and I’m going to snap, and its same thing is happening inside of the body because you know we have in our liver, in our muscles, we store reserves. We store glycogen. So, when we don’t have food or the meal is not there or we’re in a state of stress, the body can then release energy from the liver, from the muscles that stored energy and it can lock out that excess of cortisol response. And so, what we, when you’re in this state, you don’t have any reserves in the liver can store something like 400 grams and the muscles 12 to 1400 grams and that’s burned out and it’s not replaced, it’s burned out.

So, you really physiologically have no reserves and then you emotionally have no reserves and that just makes for a life where you’re living in fear and constantly on edge.

 

The connection between the brain and the central nervous system

Ari Whitten: Yeah, yeah, absolutely. So there’s several other layers to this story that you, you mentioned in passing before with the thyroid, with the central nervous system, the brain, the neurotransmitters kind of take me through your sort of model of, of how this plays out and, and what, what’s actually happening in the brain and the nervous system because that, that seems to be kind of a focus of the paradigm is the brain and the nervous system in the central nervous system needs to be rewired in a different state.

So, kind of take me through what this process of, you know, kind of this, this whole process of cellular dysfunction and nervous system dysfunction looks like, well, how does it start and what does the process look like?

Christa Orecchio: So, let’s say if we start with hormonal balance happening in the brain and we’d go back to these neurotransmitters, the chemical messengers in the brain, we have our primary inhibitory neurotransmitter called GABA.

I’m sure you know all about it and you’ve talked to about it, but its primary job is to neutralize adrenaline and so like else if we continue to overwork it, it will get depleted and then many people in this state, they’re GABA is really low and their lab work. You know, I know you’re not a huge fan of these neurotransmitter test, but they’re loud work can show that that’s happening and then there’s this domino effect and then serotonin starts to become low.

Another feels good inhibitory neurotransmitter, and then we start driving up the inflammatory process. See, because what’s happening is if you are producing too much cortisol, you are in a state of inflammation. The body produces cortisol in order to buffer inflammation.

So we can start to see this when we look at glutamate and excitatory neurotransmitter in the brain when that’s getting too high and that gets higher and higher with start to get cell death and we’re all right, now we’re having cognitive issues ran, all of a sudden our memory and we’re our brain’s foggy and those types of things are happening and it’s like we come down this cascade. So hormonal balance begins in the brain and your pituitary gland is responsible for the control over your thyroid.

So, it’s this cascade that starts to come down, which is why I’m not a fan and we’re right on the same page here with bioidentical hormone therapy. You’re treating something all the way at the end, so downstream, oh, you’re low in this, take this, you know here, low testosterone, testosterone high this, take that and it’s a band aid approach that can drive up other pathways and the way you don’t want them to.

So really all of hormonal balance begins in the brain. But when you are lit up like this for such a long period of time, you’re supposed to only be in a stress adaptive state, so the longer you’re in this state, the more you’re getting damaged to basically the electrical insulator of your nerve cells, which is called your Myelin Sheath.

This leaves you susceptible for neurological issues and disease and for pathogens and things like that to come in and to invade. And so, what we have to do is you have to address all four, so you have to basically stop the adrenals from overproducing cortisol when it’s not time for Cortisol, right? So, we can regulate rhythms.

And then you have to be able to get energy into the cell. You have to get oxygen, glucose, and thyroid hormone that has to be present in yourselves in order to make energy. And you know, all this because your nickname is the mitochondria, man.

And so, we’ve got to be able to have those in ourselves, but it’s not enough to just have them. We have to then kind of stoke the fire, right? So that we can then, once again make energy and start to in… The more your body’s making energy, the more it feels safe, the more you can shut off the sympathetic nervous system, live in the parasympathetic nervous system, but then you also have to repair the collateral damage that’s been done to the Myelin Sheath. If you want to make this your new normal, like you think about a damaged Myelin Sheath is like electrical tape and you’ve taken sandpaper to that electrical tape and it’s all frayed and fried.

Hey, you’re not experiencing trauma or stress anymore, but the damage is there, so we have to go in and soothe that and heal it and calm it. To kind of paving potholes right on a road that’s been over, traveled on, so to speak. So, you’re really. You’re working all four and that’s the only way to really move into a new, let’s say whirlpool and that’s the thing. It’s hard in the beginning because of whirlpools got a mind of its own and it’s flying on its own.

So, you have to constantly interrupt the pattern. I want to talk next about our six pillar strategy. That’s going to interrupt this pattern and get you where you want to go, but it’s going to require vigilance, but then ultimately the healing happens and the whirlpool reverses on its own, in the right direction and it’s normal and natural for you to live in your parasympathetic nervous system, to convert your food into fuel, to make energy, and to really live a completely different life. I mean, we’re talking about the trajectory of two completely different existences here.

Ari Whitten:   Okay, so we are disrupting neurotransmitters in the brain. We’re disrupting hormones and we have a deficit in our ability to drive nutrients and oxygen into the cell where it can be made into energy.

Christa Orecchio: Yes. As well as the deficit in key micro nutrients and key vitamins, minerals and trace minerals. That being in this state for too long just starts to deplete them from the body.

Ari Whitten: Okay so, and so. That paradigm is, is basically the fundamental sort of driver of most chronic disease from your perspective. Correct? Or is it more like a specific kind of symptoms and syndrome?

Christa Orecchio: It’s more for the symptoms that I’ve mentioned? You know, I’ve been in a microbiome rejuvenation for a really long time, so you can’t discount having heavy, heavy pathogenic exposure. So, it’s more kind of talking about different paths at the same mountain.

Ari Whitten: Got ya.

Christa Orecchio: Not going to say it’s the be all end all because if you’re coming and you have outrageous SIBO and you’ve, you know, you’ve, you’ve taken 30 rounds of antibiotics, you know, then then this is going to be the next step after you rejuvenate your microbiome and reeducate your immune system.

 

The 6 pillars of health

Ari Whitten: Excellent. Okay. So, from here, understanding these sorts of layers of dysfunction, result in those symptoms that you’ve mentioned, what is, what does the path look like from your model as far as fixing this and, and interrupting that whirlpool, so to speak and rewiring somebody central nervous system into a different, a different mode.

Christa Orecchio:  Yeah. So, we have six pillars if you will, that go through and be able to do this. And the first is to use synergistic foods that support all four systems that replace the nutrient deficiencies in micronutrients, but they were also metabolic foods. Which means simply they’re just easy to digest.

So you were giving the body easy to digest foods and the right combinations so that the body, once again can get the food into the cell without it having to work for it, like you really aren’t going to be giving your body foods that it has to be able to convert into other forms of energy to be able to use. So that’s going to be really important. And so, we’re going to be looking at increasing, you know, just in terms of micronutrients, you’ve got to increase a lot of your trace minerals that are just zapped.

And so, you know, increasing the amount of salt. So many people are in this situation are really going to be craving salt anyway. So, using Himalayan pink salt, Celtic Sea salt is going to be really helpful. Getting your trace minerals. Magnesium is crucial for the liver and the thyroid and the body can’t produce glutathione, which is the master antioxidant in the liver, if it doesn’t have enough magnesium, vitamin B, one, the thyroid needs more of that. It’s so involved in cellular energy and in the Krebs Cycle.

And so, we’re, you really want to make sure you’re focusing on foods that are metabolic, easy to digest and you know, we just want to constantly interrupt that pattern. And then food frequency is going to be really important because again, you don’t have enough glycogen reserves, so you have to do for the body what right now in this state, it’s unable to do for itself, which is you need to regulate blood sugar and just give it food it can use.

And so, having food frequency and eating more often, you’ll be able to constantly interrupt the stress pattern.

 

Foods that are synergistic with overcoming stress, anxiety, and fatigue

Ari Whitten: Okay. So that’s number one end to correct. Yeah. Okay. So, I have a couple of questions digging into this a bit more. Let’s go back to number one, which is synergistic foods, sort of metabolic healing foods. Can you give a couple specific examples of foods that fit that category?

Christa Orecchio: Yeah, so it’s, it’s foods, but it’s also the combination of foods. And so, a lot of people probably aren’t going to like this, but organ meats are really a very metabolic food, more so than muscle meats. I’m not a fan of them. I take the pills, instead of eating them, but you know, you can get fancy and starts and mixed them in with other meats and so for those who are eating muscle meat, like they could mix in organ meat with that or you know, we’re having them have metabolic proteins and so egg yolks and not the whites because of sensitivities.

Shellfish is more of metabolic, low fat white fish. If you’re going to have any time you’re going to have meat like beef or bison, like you’re always gonna have it with a little bit of broth or college and because the combination of those two proteins and adding in the collagen in the broth is going to allow your body to use those wonderful nutrients that are going to be in the grass fed beef.

It’s going to allow your body to actually use it instead of trying to work to be able to use it. So that’s like in terms of meats and then we’re using vegetables that are. And can I will, you and I talked about this at lunch, like we’re getting rid of that fear of carbs. Like in a lot of ways, this is the ketogenic recovery program because the body, you’re going to force your body to overproduce stress hormones. If 70 percent of your calories coming from fat or even sometimes it’s 50 percent of your calories are coming from fat, you’re going to force what you don’t want is for your body to not run off of glucose, but to run right. You don’t necessarily want your body to be running off of fat.

And so, we really want people to be able to use fruit and root vegetables strategically for energy in these early healing foods.

When you combine them with protein, and you combine them with fats that are going to be able to get our reaction to then get glucose into the cell to then that’s the antidote to stress is sugar. And we all know that because you’ve got a crazy sugar addiction problem in the US. I mean, I used to eat sour patch kids for lunch way back in the day, so I know that.

And so, it’s like, no, let’s solve that body’s need for sugar by giving it healthy, supportive micro, nutrient dense fruit that fruit and root vegetables and so combining them in the right way and all of my other programs don’t include dairy because so much with them or for the immune system in the gut, but using really high quality dairy and things like raw milk. It’s the perfect blend of proteins, carbs and fats to shut off the nervous system response to feed the thyroid, without the thyroid having to work for it at all, loaded with the amino acids that you need. And so, yeah, I’m a fan of it for this, for this purpose.

Ari Whitten: Gotcha. Okay. So I have a barrage of questions for you to go into here, but let’s start with, I think probably the most controversial element in what you said, which is that we were now living in a, in a, in a dietary sort of trend where everybody’s saying the opposite of what you said in the sense that everybody’s saying, hey, you don’t want to be a carb burner or a sugar burner to a fat burner. And so, you need to get rid of, get the carbs out of your diet, eat a low carb high fat diet, or a keto, or even there are even people saying a zero-carb diet.

So, we want to be running on, on only fat. And there are even people who kind of invoke a similar sort of logic and they say, well, that eliminates the sort of blood sugar surges that you would get if you consume a carb-based diet.

And to be clear, I’m acting as an impartial. I’m questioner here to try to try to just, you know, devil’s advocate, so to speak. I’m not saying I agree with the keto people were the carnivore diet people by any means. But I do want to pose that question to you so that you can sort of take on what, why are you not one of these people saying get the carbs out of your diet and you want to be a fat burner instead of a sugar burner. You’re saying you want to be a carber. Why is that?

Christa Orecchio: Yeah. I like the idea of slowing the release of glucose throughout your system through using, through using fat, you know, strategically in that way and there are some people where they can go on a ketogenic diet and they can heal, and they can lose weight for three weeks to maybe a couple of months. But if you keep your body and that’s where it can be helpful, but if you keep your body in that state for too long, well first of all you’re challenging your gallbladder because it’s a lot of fat and gallbladders probably going to start having trouble producing bile.

And we’ve had about a lot of people with gallbladder problems from eating this way for an extended period of time. So, I think that there’s no one right dietary theory. It’s like what are you using now and what are you using to heal? And if you’re going to be running off of fat, which you can, but that is not the body’s preferred source of fuel.

And if you’re going to be doing that extended period of time, it’s going to stress the body’s going to put you in a in it. It’s going to put you in a catabolic state where you have to break down tissue to continue that and you can see it with people who have, who know it had this one guy who had been in Ketosis for three years. I mean they start to lose the in their teeth, and they start to have chronic halitosis and it puts us in this state of breakdown that we don’t need to be in. And then we have to recover from that.

So, I think that if you’re under the care of a practitioner using the Ketogenic Diet therapeutically to heal and you’re working specifically, that’s fine, but I don’t think it’s a way of life.

Ari Whitten: Yeah. Okay. So, sticking with nutrition a little bit more before we go on. Regarding the glycogen stores thing and kind of that most people are, are not, that, don’t have, don’t have significant enough reserves. What about the people who are extremely overweight and who are generally speaking chronically overeating relative to how much they’re burning each day and um, are, are essentially in a caloric surplus, and I think most would argue are chronically full in terms of their glycogen reserves.

So, is that, how do you sort of differentiate that kind of person that you’re talking about? Is it…?

Christa Orecchio: I wouldn’t say necessarily their glycogen reserves are full because they’re probably eating the kinds of foods that they can’t create storage from. And so, so just to be clear, our program, if you’re not eating more so, so you’re not necessarily eating more calories, reading the right types of calories, the right macronutrients, the right combination of proteins, carbs and fats to shut off the stress response.

And so, someone coming in who’s overweight and having too many calories is there’ll be scaling back their calories, the probably lose weight fairly quickly and especially from regulating your blood sugar because we know that the body stores fat when you have too much cortisol on for too long. And then there’s the opposite to the opposite point that you said is we’ve got a lot of people that they say, I don’t get it. I am stressed all the time, don’t. I don’t really eat that much. And I exercise.

And so, it’s, it’s kind of goes back to the beginning of do we believe in adrenal fatigue, but this really just comes back to balance. It’s like give the body what it needs to convert food into fuel and to burn it efficiently. And then that will create an efficient metabolism, right? The thyroid, the furnace and the thermostat of the human body. We create the sufficient metabolism and then wait, works itself out on its own and then efficient glycogen stores are, are reserved again.

 

Why Christa recommends frequent meals throughout the day

Ari Whitten: Gotcha. Okay. So, one more question here before we go on. Went with regards to food frequency. It sounds like you’re an advocate of eating a little bit more on the frequent side because people have blood sugar, have trouble regulating blood sugar levels in between meals may go hypoglycemic and have their energy levels drop and brain function drop and that sort of thing and then kind of have to have a stress hormone surge and that sort of thing.

With that in mind, you know, coming, coming from that paradigm, what is your perception of the very popular trend of intermittent fasting now with people having one meal a day or you know, doing prolonged fasting of various kinds?

Christa Orecchio: It really depends on the state of their nervous system, you know, if you, if you have anxiety and that you’re the type of person who struggles with anxiety and insomnia, like that’s not going to be great for you. -but if you already resourced and your nervous system’s fine and you can, you can intermittent fast and you can sleep at night and still have energy and you’re not locked in that state of fear and overwhelm.

Then, kind of go back to the same thing as ketogenic. I don’t think I would do it as a lifestyle because that could start to cause its own issue, but it’s like we’re living breathing organism. Right?

And like life happens and all these different events happen that shift our hormones and shift our perception and our story and so I think we have to be open to changing as we go. Intermittent fasting is not going to work for the person that we’re trying to help with the adrenal recode.

Ari Whitten: Got It. So well before. So, number two is food frequency to regulate blood sugar. Is there. Before we go on to number three, is there anything else you’d want to mention on, on that point?

Christa Orecchio: You know, I think I do, Ari, because somebody coming into this that is coming off of intermittent fasting or they’re coming off of the ketogenic diet or if you’ve, you know, you, you have to work with your own body. And so that’s where we’re working with a team of five clinicians to help people. You can’t go from eating once or twice a day to eating six times a day. You will gain a lot of weight quickly.

You can’t go from eating no fruit or root vegetables, you know, which that’s pretty much, you know, our next pillar, which we talked about, but you can’t go from not eating any to then having them with every meal and not gain weight.

So, it’s meeting people where they are, you know, it’s like whatever, wherever you’re eating now, one or two meals a day, just increase it by one and I’m not talking about increasing the amount of food you’re eating, it’s just spacing it out like so smaller meals more frequently. And then the same thing, you know, if you’ve come from not eating any fruits and you know you’ve got that, then you’re going to start off with an eighth of a cup with breakfast and see how that works for you and because again, you have to work and we’ve got to sensitize yourselves once again to these foods so that they can use them instead of just converting right to fat.

Ari Whitten: Yeah. Gotcha. So, fruit and fruit sugar, fruit in roots. So, we’re in this at this point, we’re talking carbohydrate dominant foods and why fruit and root vegetables as opposed to legumes or whole grains and that sort of thing.

Christa Orecchio: What gives because they’re easier to digest. So, someone who’s been in this state for a while, the more you secrete cortisol, the more you can send the lining of your gut in the last. You’ve really digesting and so I like Legos and I like gluten free grains. I’m kind of on the fringe with that, but they have…

Ari Whitten: I’m with you on that by the way.

Christa Orecchio: I remember it and I appreciate that. It’s like it’s. It’s making healthier foods and they’ll be able to in the “Adrenal Recode” they’ll be able to add some of those foods in once they get a certain level of healing, but they have some anti nutrients called lectins or phytic acid or it’s just that it goes back to just let’s make this as easy as possible here. You don’t have to do any work. Just take the food and use it and then when you get a little strength and we’d get a little resilience.

It’s like, here you have to do a little converting. You have to, you know, do a little work to get the nutrients out of this food, but you’re stronger now in your body can do it, no problem. And so that’s when you can start to add those foods back in. And for us it takes. People come into our program and they take a questionnaire and they’ll be put in one of two tiers based upon the severity of what’s going on in their nervous system and the second tier they’re going to have to wait awhile before they can add those foods in because they have to ascertain a certain level of healing. But then the first tier is going to be able to handle those foods in moderation. So, it’s all just depends on, on your current state of health.

Ari Whitten: Excellent. So, within the category of fruit and roots, do you have any, um, particular recommendations on specific types of fruits and or root vegetables that you find extremely beneficial?

Christa Orecchio: Yeah, we’re always given love sweet potatoes and for this I like, I like white potatoes. We put the resistant starches like cassava where those are going to be, you’re going to have them in a little bit later. In terms of, of fruit, a lot of the tropical fruits are really going to do the trick and that is because they do have a little bit of a higher sugar content. And so, we’re talking things like pineapple and mango and Papaya, full of enzymes, also really easy for the body to digest. Grapes, peeled pears and apples because you’re going to take off the skin just for easier digestibility and have them cooked. And so those are kind of the fruits that you’re going to focus on and grapes and melon. And then we have some, some structure for food combining there, we don’t combine fruit and roots together so you can choose what your carbohydrate it’s going to be at that particular meal.

 

Why fat (in the right amounts) is important

Ari Whitten: Got It. What is next pillar number four,

Christa Orecchio: what pillar number four? We had a brief chat about this is the targeted use of saturated fat to protect the nervous system. So, we know that we need vitamin A, vitamin E, vitamin D and vitamin K to protect and support our nervous system. But you know, these vitamins do a whole host of things for the rest of the body as well. And so when we’re in this, we can call it an unstable state because when we’re talking about fats, when you’re healing something like this, you’re going to want 50 percent of your fats to come from a saturated source and so it’s not that you’re eating more fat, but you’re just working and then 45 percent are going to come from a monounsaturated like avocado and olive oil and only five percent from the polyunsaturated because those can be the ones that can drive up, see inflammation process the most because they’re the most unstable of the fat.

So, it’s not that they’re bad when I’m saying a poly unsaturated fat like almonds, right? When you’re talking about nuts and seeds, it’s not that they’re bad and say, we were talking, and you said what? There’re endless studies about the health benefits of nuts and seeds and there are inherent, they’re healthy foods, but just the nature of the long chain molecule, not having hydrogen attached to it on all sides leaves it unstable. Right?

This is why we want to put nuts and seeds in the refrigerator in an airtight container because they’re sensitive to light, heat, and air, and so the saturated fats are not the healthy, high quality saturated fats like the good animal fats and butter and ghee and coconut oil. Those are going to help create more stability within the body as you’re going through your healing process and so the right amount and structure fat is really important to healing. And so, it’s like the right macro ratio of fat and then also the right combination of the fat that you’re eating.

Ari Whitten: Gotcha. So, you’re in an interesting territory here with regards to your views on some food groups and macronutrients and it like it’s, you’re a little bit in no man’s land to some extent.

Christa Orecchio: That’s how my career has gone.

 

The difference between Christa Orecchio’s and Ray Peat’s work

Ari Whitten: So, what I, what I mean by that is in general, the people who are advocates of lots of saturated fat consumption are generally low carb, Ketoadvocates that sort of crowd and they’re promoting, you know, the idea that consuming lots of saturated fats is really good for you. and then those people are generally, they would not agree with you that people should be carbburners and people are not getting enough carbs and that people should be prioritizing fruits and root vegetables and you know, you are consuming carbs frequently to avoid stress responses.

They would not agree with you on any of those things. And then you have the sort of, you know, some, some other crowds that might agree with you on the carb burner thing, like let’s say a lot of the Vegan diet or Vegan Diet Gurus, but who would vehemently disagree with you about consuming lots of saturated fat. So, you’re, again, your kind of in a little bit of no man’s land but, but the, the person that is closest to you of all the different diet gurus is his Ray Peat.

And it sounds like you’ve been, to me, it sounds like you’ve been, maybe influenced a little bit by his mode of thinking and this certainly there are lots of layers of good stuff there. But I’m curious, you know, and first of all, am I correct that you have been influences?

Christa Orecchio: Yes, about five years ago I really got into, into re Pete’s work and um, I took a lot of powerful influence and started using that in my practice, started using it for myself. But I just want to touch back with you for a second. The saturated fat, like, so to be clear, we’re not, you know, it’s all within reason, so it’s, it’s, it’s within balance.

So, a lot of people, they might not even end up eating more saturated fat than they were eating before this just manipulating the ratio.

Ari Whitten: Gotcha.

Christa Orecchio: We don’t realize it. Like if you’re going to eat something, like if you’re going to make a steak right, and you’re going to add more fat to that, that’s going to be too much saturated fat if you’re going to cook that steak in butter. So, I’m not advocating an overabundance of saturated fat. If that makes sense.

Ari Whitten: Gotcha. So on, this is just my own curiosity on this point. At this point on with regards to Ray Peat. Ray Peat, I think from my perspective, this is my judgment on, you know, being very familiar with what he teaches myself. Yeah, I definitely think there are layers of good stuff there. There’re also some layers that to me just appear wildly out of connection with the existing body of evidence.

And I’ll give you a couple examples just to see. I’m curious whether you agree or don’t agree with his take on things. One thing he’s an advocate of is sterilizing the gut, so like having a sterile microbiome like he, he will cite  research for example, in in rats where they showed that sterilizing the microbiome through use of antibiotics to essentially kill everything in the microbiome was associated with this or that benefit and so he’ll use that as an example to say sterile microbiomes are better than having a microbiome full of lots of diversity of organisms. Like I think pretty much every microbiome scientist would agree with at this point.

Christa Orecchio: That has been wholly disproven. Like time again. Yeah. So, I’m just kind of like what we talked about, you know, when we talked about the institute for Integrative Nutrition, I [inaudible]. It’s just like what I love is how they can put together just a myriad of dietary theories and there’s so many. There’s no one right one out there, but there’s pearls of wisdom from each one and that’s why I left private practice. It’s like, oh, I can take this from that directory, this one, that one, this one, and put this together in such a unique way that helps this individual person. Right. And so, I’ve, I’ve taken 15,000 people through microbiome rejuvenation and I will tell you that is wholly wrong.

Ari Whitten: That’s exactly why I brought that up is because I know I know your background and specializing in the microbiome. So, I figured there must be no chance that you could possibly agree with that, which I’m glad to hear as the case. But a couple of other examples.

One is Peat opposes consumption of Greens, so like green leafy vegetables, he does not advocate and in general advisor advises avoiding fibers. So, like he’ll advise consuming orange juice but no pulp, no, like only the juice of the orange without any pulp.

Christa Orecchio: That depends. And so first of all, I’m not a fan of not eating Greens and so they are loaded with micronutrients in his whole take on that. I don’t agree with, I don’t actually know if there’s any tangible research on it where he says that they have their own inherent pesticide factory that they grow with and to keep invaders from, from eating them. So, then we eat that, but we, we feel better. We know the micronutrients, we know the studies are there, but it’s within moderation for me fo r Oxalis, right? I don’t want you drinking 32 ounces of green juice every day and so even healthy food within the right balance and moderation. And I’m sorry, what was right after greens? What? What was it?

Ari Whitten:  What was that?

Christa Orecchio: The orange juice instead. So, so my take on that is not a Ray Pete’s take. It’s just what amount of fiber can a person handle because now I’m going back to putting on my microbiome rejuvenation hat and the people that were coming to me with SIBO and parasitic infections, multiple autoimmune disorders know they actually, they’re buying doesn’t know what to with that fiber. In the end, if you have a microbiome that you have too much, too many different pathogens driving, which most people with microbiome imbalance do.

Let’s say they’re flipped like 80 percent bad pathogens, 20 percent good, and then you start feeding it with fiber and prebiotics like you are not sure what you’re feeding in there. So, we suspend most of most additional fibers. We suspend most additional fibers until we understand that we have now re-seeded, we understand the diversity in there, we know what we’re feeding instead of just throwing lighter fluid on like something hap hazard. Right? So, it’s not that I agree or disagree with Ray Peat in that sense. It really comes  down to what are you digesting and how.

Ari Whitten: Yeah, and to be clear, I actually agree with your point, but that isn’t his take on it. He doesn’t present a nuanced version of that where it’s like don’t do fiber, if your microbiome is dissed, if you have dysbiosis and want to assess that and then you know up your fiber. If you have a good microbiome, his take is like more of a blanket sort of in general and it’s maybe, you know, hardcore Ray Peat advocates would maybe accuse me of slightly misrepresenting this, but I’d say overall, most people who study Ray Peat come away with the conclusion that Greens are bad essentially like period.

And that gen one should avoid fiber and avoid orange juice, orange fruit, fiber and greens, you know, fiber from greens and fiber from legumes and things like that. And I think, you know, to me this is just wildly out of, um, out of congruent with the overall body of evidence.

But I do agree with certainly your exception to the rule that if somebody has dysbiosis, certainly feeding it with lots of, even the stuff that has good evidence for it, some of the prebiotic fibers can create problems in those people. 100%.

Christa Orecchio: Yeah. Not to get too far into digestive health, fitness, like, yeah, but if for whenever you’re healing the gut, you have to flash the inflammatory process. You’ve got to suspend it, and then you have to interrupt pathogen production, right? You have to interrupt the way these pathogens communicate so that they can no longer communicate, they can no longer replicate, they can’t share their genetic code anymore. And so that’s, you interfere with that step if you were haphazardly using fiber and prebiotics. Right.

And then once you know, once you’ve got that under control, that’s when you would receive with really specific strains of probiotics. Right. Because you can mess up putting probiotics into early as well and so that’s when you know what you’re working with and you can reseed with probiotics and then you get to. Then you can start to add in prebiotics, probiotics, optimize hydrochloric acid and you know, really kind of get the body working again on its own and not tend to the garden, so to speak.

Ari Whitten:  Yeah. I’m with you. Final Ray Peat question.

Christa Orecchio: Yeah. More about Ray Peat than I do to be honest. I didn’t study it.

Ari Whitten: Yeah. I, I, many years ago I went through a Ray Peat phase. You know, I’ve, I’ve been through a lot of phases. I was, you know, it’s funny to me that Keto is popular now. I was doing keto when I was 17 years old and you’re nearly 20 years ago before anybody knew what Keto was and so raised.

Christa Orecchio: You’re raising holistic household though, right?

Ari Whitten: I was also, you know, I started when I was 14 years old. My older brother was a personal trainer and a bodybuilder. And so, I… And then I had a very obsessive personality, so whenever I got interested in something and sort of all I wanted to do and you know, well let’s just say I’ve been interested in nutrition and health for 20 some years now. It’s been a, it’s been a long, long time and it, and I have a bit of an extreme personality too, so I’ve been on lots of very extreme diets of chugging, you know, cream and, and red meat diets and everything to that from raw veganism and sort of everything in between. But Yeah, Ray Peat was certainly one of my phases.

Christa Orecchio: I think it’s good because it makes you relatable, right? Like I’m maybe not to that extreme, but definitely use… I’ve been my own lab rat. I’m trying. Okay. Before I can recommend something, I want to see what my experience of it is, you know, within my own body and my own state.

Ari Whitten: Totally. So, one other aspect to Ray Peat is sugar. He is a, and I think he’s probably literally the only nutrition guru who has this stance regardless of side, of all the different sort of diet cults. I’m pretty sure he’s alone on this one, which has refined sugar consumption. He is actually an advocate of it and advises people to even like add refined sugar into orange juice or into milk and consume extra sugar with the idea in mind that it’s combating stress hormones. So, what, what is, what is your take on that?

Christa Orecchio: Yeah. I’m like, uh, I vehemently opposed to that. Especially when I say, you know, I say I was raised on pizza, pasta, and antibiotics. You know I was such a sugar junkie and have helped so many people heal from sugar addiction. And it is real. I mean, it lights up dopamine in the brain, but at the same way, right. The study showed same way heroin does, so we can’t use the white stuff that kills the good gut bacteria. It leeches your b vitamins at Leeches, your minerals so that that would be a trying to rob Peter to pay Paul type of the situation.

But using fruit and root where you’re giving something that has the natural easy to digest fiber that slows the release of glucose to deliver it in a steady way. That’s the type of sugar that we’re talking about and it’s loaded with these micro nutrients that you’re deficient in any way.

It’s like, yeah, that’s the type of sugar that I’m a fan of and have been since the beginning of my career 15 years ago.

 

Ari’s secret snack favorite

Ari Whitten:   Yeah, I’m with you on that. And I eat a ton of fruit and I will also say that purple sweet potatoes are, are my weakness. I love purple sweet potatoes and especially, I mean there’s so many good ways to eat them, but especially when you, you bake them, like you make them into wedges and then you bake. I’m sort like thick cut fries but baked instead of fried.

Christa Orecchio: Yeah.

Ari Whitten: And I get a little, you know, I’ll get, I’ll get this. This is one of my secrets I’m releasing now to the world for the first time, but a little bit of honey with some cinnamon as a little bit of dipping sauce for those purple sweet potatoes. Try it. If it sounds, it might sound weird to some of you listening, but…

Christa Orecchio: I’ll try that. We use raw honey, I love raw honey. Interesting. Maybe can you put a little mustard in there too?

Ari Whitten: Now you’re weirding me out. I’m more of a sweet guy and then a savory guy

Christa Orecchio: I lean towards the mustard, [inaudible].

 

The importance of customized nutrient ratios

Ari Whitten: So anyway. Well thank you for indulging me in that Ray Peat digression, but back to your six pillars. Number five, what is number five?

Christa Orecchio: Okay. So, going back to, to his work about finding the be customized nutrient ratio. That is something I’m interested in and a fan of because you find the right amount of protein, carbs, and fats for your unique body that you need. Like I said, you can shut off the stress response and so using real time feedback, using temperature and using pulse as that marker instead of running like five labs, I would run in private practice.

It’s using temperature and pulse to see if you’re an inflammatory state where you’re not and if that meal worked for you or if it didn’t. And you know, we know that blood sugar and temperature, there’s a correlation and you can regulate your blood sugar. and there are things like ovulation and temperature and things like that, you know, of outside hot drinks that will influence temperature. So, using pulse is, is it kind of a good backup measure to see, okay, how does this, how is this meal working for or against you? Do you need more fat? Do you need more protein? Do you need more carbs? So, so helping you find that exact ratio and that has been pretty life changing for several clients that I’ve worked with, you know, for when I first started getting, you know five years ago and to this work and mine was from an entrepreneur is a mess.

How I got myself into this state and that really helped pull me out of it and subsequently so many other people with thyroid dysfunction. Really. So, um…

Ari Whitten: By the way, is it entrepreneurism or entrepreneurism?

Christa Orecchio: I think it’s both. It just depends how bad it is.

Ari Whitten: So, how does that actually work as far as measuring temperature and pulse? Do you have any sort of practical recommendations on, on how that plays out? Hang on, I’m just going to plug in

Christa Orecchio: For a second. How does that play out for measuring your temperature and pulse?

Ari Whitten: Like what, how do you recommend people go about that or, or use temperature and pulse to get any sort of useful feedback on what they consumed in whether it was good or bad for them.

Christa Orecchio:So, they should check their temperature and their pulse. I would say maybe three or four times throughout the day, like in the morning and before bed and then 20 minutes after a meal. Because if your meal work for you then your food is thermogenic, it’s going to create energy and if it didn’t work for you, you’re going to be low. And so, you want to be able to check, so you want to be within a range of 97 point six to 98 point six, you want to be roughly within that range of 36,5  Celsius to 37 Celsius if you are, if you’re working on, if you’re in the metric system.

So, and then you want to use your pulse, take your pulse should really be somewhere between 75 and 80. And so a lot of people, and you know this, this is just a testament to exercise, right? It’s like when our circulation is better and what the amazing power of exercise can do. The right exercise is we are able to, we get this thermogenic effect, and everything flows and circulation’s better. And so, it’s, when you’re in this depleted state, circulation isn’t so great and you’re, you tend to have a low pulse.

Ari Whitten: Gotcha. Excellent. So, um, as far as the measurement, 20 minutes after a meal, what they’re, what we’re looking for is that pulse shouldn’t drop too much and, and that a body temperature shouldn’t be too low. Correct?

Christa Orecchio: Correct. Yeah. And you know, I recommend you do that for three days in a row and come write down and see where you are because that’s going to give you just from whatever you’re eating changed nothing. Right? And, and do that for three days in. See, okay, am I running chronically low? Yeah. My body’s having a hard time getting out of this state. My body’s about hard time regulating blood sugar and so I probably need to make some changes to make it a little bit easier.

And you start noticing it. Like, of course,  you get cold hands and feet, right? And wait, when you have thyroid problems tend towards constipation and so you start to have those problems and that will be reflected also in temperature and pulse.

Ari Whitten: Yeah. I’m curious, have you looked, do you know who Matt Stone is? Have you looked into his work at all? Okay. He, he’s actually a friend of mine. I don’t agree with pretty much anything he says from a diet perspective and, and, and I’m sure he would say the same about me

He’s, I forget what the movement is called, but it’s something like within the sort of obesity related research community and, and sort of there’s a, there’s a particular movement and there’s one researcher in particular that has led this movement that’s sort of… it’s sort of like a body acceptance movement that the basic jest of it without. I’ll sum this up, try and I’ll try and send this up relatively quickly. But the basic gist of it is like people can’t lose weight. Like diets fail.

It’s impossible to lose weight. Anybody who does lose weight is going to gain it back so you might as well not even attempt to lose weight because it’s a total waste of time and it will eventually, not only, not only is it a waste of time, but it will actually harm you in the long run.

And there’s an element of truth in that which is that like if somebody adopts stupid, unsustainable diets in a short term basis and they’re not really making sustainable lifestyle changes, they’re just want to go on so and so extreme diet for 30 days or 60 days, try and lose the weight and then they think they’re going to be good after that and they can go back to their old habits. I agree that that’s going to be harmful in the long run if you have many cycles of that, but their view is that sort of any attempt to lose weight is a bad idea and it’s inevitable that it’s going to be counterproductive and ultimately harm your metabolic health and you’ll be fatter in the long run and unhealthier, um, and you’re torturing yourself in the process.

So, Matt Stone is part of that movement and that’s part of his general message, but he’s also part of the, he’s been heavily influenced by Ray Peat’s thinking and he’s also created a sort of his own methodology of eating that revolves specifically around temperature and pulse to some extent, but really body temperature as sort of a key guide to metabolic health. And he actually has written a book called eat for heat that is specifically about how to eat in order to keep your body temperature very high.

And, but, but it’s, it’s too, and this is the part that I really don’t agree with. He’s advocating a style of eating that is diametrically opposed to pretty much all of the nutritional evidence in the sense that he’s advocating for people to consume lots, lots of food, enough food that most people will gain lots of body fat eating the way he’s advocating and lots of processed food. And even, you know, fast food and all kinds of like junk process food he has really no problem with.

And lie I said, he’s, he, I haven’t, I have absolutely nothing against the guy. He’s a personal friend of mine. I actually love him. He’s got a great sense of humor. He’s a super nice guy.

But as far as I’m concerned, like his dietary methodologies are I think counterproductive. Uh, and so anyway, I think you can, I mean certainly you can take anything to an extreme where it’s harmful, but this is an example of I think just someone who has taken the kind of idea of temperature as an indicator of metabolic health too. Like he’s like, you know, eat tons, tons and tons of refined carbs and salt then that’s going to elevate your body temperature. And I think it just gets really…

Christa Orecchio: And it does. Salt, and sugar does elevate your, by the way, to get yourself really sick really fast. Okay. So, to that end, I have to say, first of all, my whole approach to health throughout my private practice and everything, people come, they want to gain weight or lose weight. They want this, they want that. It’s just what’s going on in their body and how do we create balance. They can have whatever goals they want. If we can create balance, the body will heal itself. That’s just fundamental health.

Right, and so without going on too much of a tangent, like a month or so ago, I went to a woman in science event at the Salk Institute in La Jolla and they were they. It was an art exhibit and so it. It was all these organisms done in art and it was so cool because they talked about how art and science meet each other, right? How, how science is.

Science is the subject is the objective assessment. Art is the art is going to be. Your art is going to be. I’m sorry, so science is going to be objective and then the art is subjective. Right? And so, it was about what the field of microscopy would not exist. The scientific field of microscopy that is changed human biology since we had it so we could understand these organs would not exist without art because of the artist’s interpretation from the scientists telling them about it. They could then draw these organisms naked and create something that they didn’t.

They couldn’t build that bridge, so you can’t just rely on lab work or you can’t just rely on any objective assessments, so, so temperature and pulse, their objective assessments and just lab work could be, but it ultimately means nothing without the overlay of the individual. Right? So, we’re having them tuning into themselves often for the first time.

And to your point has. You’re saying, what about following this person and that person in this side and not touch? It’s about shutting out the rest of the world. It’s about shutting out dogma and it’s about tuning into yourself. It’s about creating parasympathetic moments about knowing does this work for me or not? How’s my digestion? How did I sleep? What are my moods? Where’s my anxiety, what’s triggering me, how did I breathe, which is our sixth pillar, and so that by taking that subjective assessment, it will bring. Then there was going to bring the objective assessment to life and actually make it mean something. So that’s where I would differ from your friend Matt in, in one, of 100 ways. Probably.

 

The sixth pillar – breathing

Ari Whitten: Excellent. Love it. So, pillar number six. Breath.

Christa Orecchio: Yeah. So, the breath is the, it’s the remote control of the brain and the nervous system and it’s so underutilized. So, it’s really its breath and its movement because a lot of, a lot of those of us who are in this state, we can’t be doing any major detoxes and he any major cleansings we’re already depleted. And so, if you’re going to go do some crazy cleanse, you’re probably going to end up getting sicker and then generating more of these stress hormones. But oxygen is the safest and the gentlest detoxifier that we have. And so, we’re using it to be able to do that. But also, obviously, you need oxygen. You need thyroid. You need glucose inside the cell to be able to make and burn energy. And so using that combined with using specific movement through yoga, foam rolling and really just getting out again, you know, walking and moving that that’s going to help so much to be transformative and we have to be able to use the yoga and the foam rolling because when the hip flexors and[inaudible] tight, you know, they call that the junk drawers of emotional storage and that forces us to just breathe through our chest and it perpetuates the problem and forces us to stay in our sympathetic nervous system.

So again, it’s just a holistic approach to opening up the body in a way and being conscious of breathing in your, we call them parasympathetic moments. So, throughout your day, being conscious of breathing your exhalations, extending them longer than your inhalation. And then

also doing, you know, targeted five-minute, five-minute exercises twice a day to your breathing.

Ari Whitten: Excellent. Five-minute breath related exercises.

Christa Orecchio: Yeah.

Ari Whitten: Gotcha. Cool. So, the last part of this, these are the six pillars, but these are really sort of addressing the physical side of health. I know one of the things we talked about in person is you are a big believer in the idea that, and certainly there’s lots of science to back you up on this, that emotional health, psychological health, and you could also use the word spiritual aspects of things are, are also a big factor in our health.

So, talk to me about what you think is going on there.

Christa Orecchio: Yeah. So, so the second part of this is because this is called the adrenal recode, and what we really want to do is help people recode in a way that’s permanent, no way that they can live healthy, completely different life going forward. So, you can do the physical healing, but then what happens the next time a major life stressor comes down the pike, which it probably will because we’re all having a human experience is what are your normal ways of reacting? You know, what is that? Because you have a thought and that thought leads to an emotion and that emotion drives your physiological process. is going to drive the release of cortisol. It’s going to drive up, you know, it’s going to force the release of adrenaline first and then cortisol.

And so how can we start to respond to life instead of reacting to life and so this entire second part of this is we really start with is emotional mastery, so to speak is recoding, creating new mental-emotional  patterns and ways of responding. I don’t know how much time we have or how much you want me to get into it.

Ari Whitten: We have like five or 10 minutes more where we’re a little over time, but this is good stuff. I’m happy to go a little overtime as long as you have time.

Christa Orecchio: This is a really long podcast. Yeah, so. So, I’ll give you the example and I’m my own what this to me is my most personal work that I’ve done in my career in, in the last since I started the whole journey 13 years ago. And so yes, I’ve done this work. Yes, I know how to balance my neurotransmitters and thyroid and adrenals and I pulled myself out from entrepreneurism using this whole physical approach, but there was still that constant. It’s a constant the way you respond to stress.

And so, I had a major stressful situation happened, which I filed for divorce when I was two months pregnant to escape an abusive situation. That’s a pretty intense thing to go through, but you are growing this child and you have all these fears, right? Like how I am going to keep him safe and me safe from, from you know, the abuse.

How am I going to be the sole provider? How am I going to go through this stuff alone? You could really go down a rabbit hole and a lot of people have a lot of things going on that can really take you down a rabbit hole into fear and you’ve got to find a way to get in your elevator and press the button and rise above the energy of fear and intimidation so that you don’t feel it. And I had more motivation than I’ve ever had in my life because it wasn’t just about me anymore. What that stress would do to my body is I am a holistic person. I wrote a book on fertility and prenatal health. I was not going to let my son incubator in a body that was filled with stress hormones and so that’s when I started diving in and developing part two of the adrenal recode.

Well, I wasn’t developing it for the Adrenal recode is developing for myself. I want to pay it forward and be able to share it and so that’s where that came from and so we focus on dismantling limiting beliefs. That’s the beginning. That’s just one of four modules. That’s within the Adrenal recode program is these are beliefs that we all. I don’t know how much you’ve dove into this because they know her so well researched. It’s been a long-time studying psychology, but you know, we do create a set of layers of limiting beliefs from age zero to seven.

Like we’re, we’re egocentric. We have no other way to be as children and so you develop limiting beliefs and for me mine was, I have to do everything by myself. It’s not true, but when thought and belief and life experience combined, you’re locked into a way of being and so that ended up.

I kind of attracted this whole situation. I was able to be able to take accountability for bringing that forth and then to dismantle it and have now more support, more love, more everything that I’ve always wanted in my life as a result of going through what I went through and being able to recode and that there’s more to that story, but unless you can do this work and then you really learn to take that accountability to do the forgiveness work, that’s when you can have genuine gratitude for the endless things there are that every one of us has to be grateful for in life, and that’s when you can start to really live in your essence and claim your power as a human being. That’s always been there. It’s just kind of removing the layers and so the record is about healing physically and learning how to create this emotional mastery, so you don’t react out of past fear or triggers. You’re responding as your present self to a present situation so you don’t end up back there physically again and life will happen. So, we’ll teach you how to integrate and kind of do the dance as life goes on.

Ari Whitten: Excellent. What, what is your preferred sort of methodologies around how to accomplish that sort of recoding of, of limiting beliefs and that sort of thing. Do you have any particular techniques that you favor or anything like that?

Christa Orecchio: Yes, but if we only have a few minutes, I don’t know how, how…

Ari Whitten: You can name it if you want or give like a very brief overview of it. Yeah. I don’t expect you to guide us through the technique practically or.

Christa Orecchio: Yes, so and we’re were working on a, a to two women who were life coaches for Tony Robbins for about a decade and we teamed up with this process of helping people, first of all, understand where like what are sample beliefs and understanding that you have. You have a memorized self and you have a present self. And the memorized self this just is like, we need that because we don’t need. We don’t want to be president every time we’re driving, or we want to be able to walk into gum at the same time. You need to memorize self for those things. But what happens is we, we, we lock in this way of behaving from what we observed, and we lock that in as our memorized selves and that’s our way of responding and reacting to things.

And you know, unlike you, I was raised in a very reactive household, not a holistic household, not a holistic, you know, and it was, it was that whole Italian, New Jersey.

Everything’s a big deal, that type of thing, which there’s a lot of love there too. but you learned that overreaction is just the… that’s just reacting, right? And so everybody has to be able to understand, okay, and then we will work to have them understand what their memorized self is and what are these beliefs and when we just work on the limiting beliefs, one or two, because there are layers that are going to be the big rocks that are going to put them back into this nervous system dysfunction.

And we work and we start to examine the beliefs. And I really liked the work of Byron Katie. I like the work of Joe Dispenza. I like the work of Bruce Lipton and we’re really starting to examine the beliefs and we’re starting to then dismantle them. Starting to question them, start to dismantle them and kind of poke holes in the story so, so the light can get in, you know. so, then we can start to get the truth in there and then we can start to then revolve the belief, and I’m really grossly oversimplifying it for the sake of time.

But you, you have to also release trapped negative emotions from the body. And that’s one big thing that really helped me as I worked privately with a sematic therapist because emotions are stored in our body and we just like, we have to eliminate toxins. These negative emotions, they are toxins. They need to be released. just like we have to change your diet. We release them, we replace them with positive emotions and it’s a new way of operating going forward. But just like we have to constantly interrupt that pattern of living off stress hormones through the physiological approach. You have to constantly interrupt the pattern. The tape that’s been running in your head for 20, 30 or 40 years, so that’s another biochemical shift, but not until you get the physical healing to where you feel calmer, quieter. Are you going to be open to doing the next level of work that’s going to really make sure you don’t end up back there?

 

The Adrenal Recode

Ari Whitten: Excellent. I love it. Well, Christa, this has been an absolute pleasure. I’ve really enjoyed this conversation and I love the nuance and sophistication and critical thinking that you’re bringing to a lot of these other ideas that are floating around on the diet sort of interwebs. And uh, I really appreciate the perspective that you’re sharing and this paradigm I think is extremely useful and beneficial for people.

So, you’re launching the Adrenal Recode. when are you launching that?

Christa Orecchio: Yeah, so you’ll be able to enroll in tearing on recode from December 18th through January sixth and then it goes away because we all go live together and we implement this on January eighth, but I have a free mini course for everyone with action items, so things you can start eating and doing right away, going out on the 11th and all of that is at the adrenalrecode.com.  Yep.

Ari Whitten: Well we’ll put a link to that on the podcast page for this episode as well, the energy blueprint.com/Christa, and maybe we’ll talk after this podcast episode if you can arrange any sort of discount code for, for my audience or anything like that that we can have sort of a special link there. And we’ll put that link on theenergyblueprint.com/Christa. And so, you’ll have a series of videos, like a free masterclass or masterclass videos that you’ll release.

Christa Orecchio: Yeah. And, and so everything that we talked about today, it’s like, okay, here, do these three action items today and then build off of those action items for the rest of the course.

Ari Whitten: Excellent, so I will release this podcast during that time so that since there’s a very tight window and obviously it wouldn’t make sense to release this podcast two weeks after this window and have a lot of angry emails from people, uh, so I’ll make sure to release it either just before those dates or during that window and people can get access to the free masterclass and, excellent.

Well, Christa, thank you so much. It’s been an absolute pleasure and I hope to do this again with you sometime soon.

Christa Orecchio: Yes, likewise. Thanks for having me, Ari.

Ari Whitten: Yeah, my pleasure.

How To Overcome Anxiety and Stress, And Increase Your Energy with Christa Orecchio – Show Notes

What it means to live off stress hormones (1:30)
Why most people stay in stress mode (8:59)
The connection between the brain and the central nervous system (13:21)
The 6 pillars of health (19:30)
Foods that are synergistic with overcoming stress, anxiety, and fatigue (21:42)
Why Christa recommends frequent meals throughout the day (29:47)
Why fat (in the right amounts) is important (35:48)
The difference between Christa Orecchio’s and Ray Peat’s work (38:07)
Ari’s favorite snack (49:57)
The importance of customized nutrient ratios (51:00)
The sixth pillar – breathing (1:01:15)
The Adrenal Recode (1:12:24)

Links

Get Christa’s Adrenal ReCode here

 

 

If you want to learn more about how to heal your gut, listen to the podcast with Summer Bock from guts and glory

The Top 12 Natural Sleep Supplements

Sleep supplements | The Top 12 Sleep Supplements, theenergyblueprint.comLooking for the most effective, science-backed supplements for deep sleep? Then you’ve come to the right place, as you’re about to learn the most effective sleep supplements that will help you get to sleep faster and sleep deeper during the night. Sleep is critical for energy levels, and yet, for people with disturbed sleep, it can be a jungle when you are looking to find out which are the best supplements to help sleep through the night. If you’re looking for insomnia supplements or supplements that help you sleep deep and restfully each night, then you’re in luck because, in this post, we have gathered the top 12 natural sleep supplements. (At the end of this post, I’ll also show you my recommended brands, and my top choice for most powerful sleep supplement). 

 

Deep, Restful Sleep Is Vital For Achieving Maximum Energy

Without deep, long periods of 8-9 hours of healthy, restorative sleep on a regular basis, we will accelerate the aging process, slow the metabolism, impair physical and mental performance, weaken the immune system, and predispose ourselves to a long list of diseases, including cancer, heart disease, and chronic fatigue. [1][2][3][4][5][6][7][8]

During sleep, we recharge the body and mind, repairing the body at a cellular level and performing all kinds of crucial healing functions in the body from repairing muscles, to burning fat, to releasing important hormones, and all kinds of crucial actions that are important for the health of the mind and body.

The trouble is, not enough of us are getting really good, rejuvenating reparative sleep anymore.

In fact, 60-70 million Americans and 1 in 3 individuals worldwide suffer with mild to severe insomnia. [9] Sleep problems have become an epidemic.

 

Why We Often Need Supplements To Help Sleep Through The Night

This is largely due to our faced paced, technology-saturated lifestyle which takes a huge toll on our circadian rhythms. Too much blue light, inadequate sunlight exposure, late workouts, stress, hormone disruption from environmental toxins, aging, and even your chronotype (whether you are a lark or night owl), all of it takes a toll, making it difficult for us to become sleepy when we should be—before bed, or when we’re truly exhausted from a long night on the computer working. [10]

If you want to know more about your chronotype and how that can influence on your sleep, go check out the podcast Why Your Chronotype and Circadian Rhythm Can Wreck Energy with Dr. Michael Breus, the sleep doctor. You can find it HERE!

 

Why Over-The-Counter Sleep Medications Are Bad For Your Health, Compared to Natural Sleep Supplements

Image of pills | The Top 12 Natural Sleep Supplements, theenergyblueprint.comIf you’ve tried common over-the-counter sleep medications like all the PMs and Nyquil, you’ll notice they not only stop working quite quickly, they also have the complete opposite effect upon you within 48 – 72 hours of subsequent dosing.

In fact, anti-histamine sleep aids like those can cause more rather than less sleeplessness after used for a time. This is because anti-histamines have anticholinergic effects–-meaning they block the neurotransmitter acetylcholine, thus preventing us from feeling “wakeful” and alert—not actually making us sleepy but preventing wakefulness and energy, which will quite negatively impact our energy levels the day after we take it. [11]

The problem is that acetylcholine is also the chief neurotransmitter that gives us cognitive performance and energy as well, which is why even those these might help you fall asleep on occasion, you won’t feel 100% after taking them.

Plus, in 2015, as you might have heard, researchers found a significant link between chronic use of anti-histamine medicines and sleep aids, including Benadryl, and increased risk of developing dementia and Alzheimer’s disease in older people. [12]

 

Why You Shouldn’t Use Prescription Sleep Meds

Let’s get one thing out of the way: Prescription sleep meds can be useful when used for a short period of time to re-establish sleep. And if your doctor has explicitly told you that you must be on sleeping pills due to a particular condition, please follow their orders.

But in general, most people are making a terrible mistake by going on sleeping meds. Here’s why:

These drugs are not specific to the sleep centers of the brain – they affect many aspects on your nervous system and organ systems. And do so in potentially negative ways. According to Patrick Fuller, MD, a neurologist at Harvard Medical School: “They’re not this cute little thing that comes in and targets a little cell in your brain that’s just all involved in sleep. These drugs are not that specific; they affect not just the brain, but the peripheral systems as well.” [13]

Image of sleep medicine Ambien | The Top 12 Natural Sleep Supplements, theenergyblueprint.com
Zolpidem Tartrate 10 MG TABTOR (generic Ambien)

And that’s why they all have very significant side effects. According to Drugs.com, Ambien (which is the most popular sleep drug these days) has common side effects that include drowsiness, headaches, nasal congestion, memory loss, muscle aches, double vision, diarrhea, swollen lymph nodes, voice changes, forgetfulness, belching, body aches, among others. [14] (Note: Women take longer to metabolize Ambien than men, and thus are more likely to suffer side effects the following day.)

(Note: Women take longer to metabolize Ambien than men, and thus are more likely to suffer side effects the following day.)

 

Why Herbal Remedies For Insomnia Are Better For Your Health

Sleeping pills are also highly addictive (and many cause you to build up a tolerance). Because of this, it’s extremely common for people to get stuck taking them because their body just won’t let them ween off. (And after you get off, for many people, sleep problems are often worse than they were before taking the meds).

According to Marc Leavey, MD, “At a certain point, you won’t be able to fall asleep without them. Of course, with benzos (e.g., Xanax), you get used to them — you’re addicted — so you’ll have to bump up the dose to get the same effect, and then you have increased problems as time goes on.” [15]

There is also a potential link between sleeping pill use and cancer, and one study published in the British Medical Journal found that people who took prescription sleeping pills were significantly more likely to get cancer. [16] Other research has linked their use to debilitating falls, susceptibility to infections, dementia, and heart attacks.[17]

Sleep researcher Shawn Youngstedt, Ph.D., sums all this up with a troubling comment: “Sleeping pills are extremely hazardous. They are as bad as smoking a pack of cigarettes a day.” [18]

The Most Effective Natural Herbs and Supplements To Help Sleep Through The Night

Natural sleep supplements, such as vitamins, minerals, and healthy herbs can help us to stimulate the calming and drowsy sleep receptors in the brain—helping to prepare us for a night of deep rejuvenating sleep that restores energy and enhances mental and physical performance, not inhibit it the following day.

These kinds of supplements can actually help you get your circadian rhythms regulated, allowing you to maximize your daytime energy levels and enhance performance in all you do.

Let’s talk about the best, proven sleep supplements

 

1. 5-HTP 

Why 5-HTP is one of the best sleep supplements 

In humans, 5-HTP is the immediate nutrient precursor to the neurotransmitter serotonin (5-HT) and it converts into serotonin in the brain. Your body uses tryptophan to manufacture 5-HTP, which is part of the reason for all the mythology about turkey making you sleepy from all the tryptophan. Serotonin is, of course, profoundly important for sleep and mood, as well as learning, sexual behavior, and hormone regulation among its many other roles in the human body.

One reason 5-HTP is such a good supplement for sleep is that it helps replenish the serotonin we naturally lose as we age. So, 5 HTP can help alleviate serotonin deficiencies as we age and help manufacture new serotonin as well.

Serotonin also helps us to manufacture melatonin, which is vitally important for sleep and is the chief hormone that controls our wake-sleep cycle. In several studies, 5-HTP has been shown to be beneficial in treating insomnia, especially in improving sleep quality by increasing REM sleep. [19][20][21] The research is clear that 5-HTP is one of the best sleep supplements.

 

2. GABA 

Why GABA is one of the best sleep supplements

GABA (gamma butyric acid) is a naturally occurring chemical compound produced in the brain that helps to calm the excitability of neurons. GABA is an inhibitory neurotransmitter in the brain which has suppressive effects upon the excitatory neurotransmitters norepinephrine and glutamate. And it’s one the top sleep supplements.

GABA is also intimately tied to the parasympathetic nerve system, which is our “rest and digest” system – the polar opposite of our sympathetic nervous system’s fight or flight mechanisms in the body.

People who have chronic sleep problems typically have GABA levels that are 30% below normal, as do people with mood disorders, like depression, which are tied to insomnia as well. [22]

Gaba is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.com

GABA helps to activate calming neurotransmitters in the brain helping us to get naturally sleepy. As an added bonus, GABA can also help relieve anxiety and relax the body and muscles as well. Users say taking GABA at night helps them feel very calm, drowsy, and ready for a good, long night of sleep.

  • In a study at UCLA School of Medicine of 18 people with sleep disorders, individuals who were given a GABA supplement were able to fall asleep in almost half the time it took those taking placebos and increased their time spent sleeping by approximately 73%. Before supplementation, the duration of their sleep was about 5 hours, and after supplementation, it increased to about 6.83 hours. There was virtually no change in the placebo group. [23]
  • Recently, researchers found that natural GABA has various sleep-improving effects. The researchers measured brain waves using electroencephalography (EEG) after participants took 100 milligrams (mg) of natural GABA or placebo. [24] Those who took GABA fell asleep faster and had longer quality sleep time. They also experienced enhanced periods of REM sleep and reported feeling more energized in the morning.
  • In a 2013 study on elderly men with frequent night urination, GABA proved to enhance sleep length, quality, while helping them wake up feeling less groggy in the mornings and greatly curbing nighttime urination. [25]

GABA is one of the best natural sleep supplements around for helping you get truly restorative sleep.

 

GABA + 5-HTP Together

When combined with 5-HTP GABA has proven effects of improving sleep quality and sleep duration as well. In fact, a new paper published in Life Sciences reports that a combination of GABA (γ-aminobutyric acid) and 5-HTP (5-Hydroxytryptophan) improved sleep and sleep duration more than the use of either of the two amino acids alone.

Although this study was conducted upon fruit flies, the results are significant as these flies are often used in scientific studies because, as these researchers note, “Homeostatic and circadian regulation in Drosophila are comparable to findings from mammalian sleep research.”

The reasons why these supplements work so well synergistically is because insomnia is a product of both low GABA and low serotonin levels in the brain, and when combined, these supplements boost both, greatly enhancing serotonin, GABA, and tryptophan production in the brain, helping you to get to sleep fast and deeply. [26]

 

3. L-Theanine

Why L-theanine is one of the best sleep supplements

L-Theanine is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.com

L-theanine is one of the most amazing sleep supplements. L-theanine is an amino acid that is found in abundance in some teas, especially green tea. What L-theanine does is to increase alpha wave activity in the brain, mimicking brain waves during deep sleep phases. Because of this, L-theanine increases the production of dopamine, serotonin, and GABA, which all promote sleep and elevate mood.

  • In a recent study of young males with ADHD, L-theanine improved sleep quality and length of time spent sleeping, and typically, all children with ADHD have much trouble sleeping. They also reported feeling more refreshed after sleep, that they had fewer nightmares, decreased anxiety and more relaxation at bedtime, and more energy throughout the following day as well. [27]
  • One great asset of L-theanine is that it does not cause grogginess or become addictive over time, as most sleep aids do. L-theanine has also been found to counteract the effects of caffeine (in studies with rats, to note) and promote sleep even when excessive caffeine is in the system. [28]
  • In another recent study, l-theanine helped subjects with major depressive disorder to get more restful sleep, and also produced positive effects like reducing anxiety and elevating mood. [29]

 

4. Vitamin B-6 

Why B-6 is one of the best sleep supplements

Vitamin B-6 converts a small amount of the tryptophan in your body to niacin, or vitamin B-3, and serotonin, a neurotransmitter that helps regulate sleep patterns. By failing to obtain an adequate amount of vitamin B-6 in your diet, your body’s metabolism of tryptophan may be disturbed. This may limit the amount of serotonin in your body, potentially leading to disturbed sleep patterns and insomnia. A deficiency in B6 will cause insomnia and difficulty sleeping. [30]

B6 has proven to stimulate the brain during sleep phases of REM, and individuals often say it gives them more vivid dreams. [31]

 

5. Melatonin 

Why melatonin is one of the best sleep supplements

Melatonin is best known as a natural cure for jet lag. However, many studies have shown it to be very effective for insomnia — it is one of the absolute most effective sleep supplements. In a 1996 study on 15 healthy, middle aged men and women, just 1.0 mg of melatonin proved to enhance many aspects of sleep including:Melatonin is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.com

• Actual total sleep time
• Sleep efficiency
• Non-REM Sleep
• REM Sleep Latency (how fast you get into deep sleep) [32]

In a 2005 meta-analysis of 17 studies on the efficacy of melatonin supplementation on individuals with insomnia and other sleep disorders, researchers found overwhelming that melatonin is a highly effective sleep supplement. As the researchers explain,

“A meta-analysis essentially tells ‘yes’ or ‘no’–that a treatment does or does not have a significant effect,” Wurtman said. “When a meta-analysis says ‘yes,’ there should no longer be any controversy about whether the treatment works.”
The melatonin meta-analysis delivered a definitive “yes.” [33]

In a more recent 2008 study, 5 mg of melatonin taken daily, helped shift-work nurses fall asleep more easily as well. In fact, melatonin is particularly effective helping people to fall asleep who typically have trouble falling asleep. [34]

But if you take melatonin, it’s important to be mindful of the dose, as it’s important to not overdo it.

 

6. Passion Flower

Why passion flower is one of the best sleep supplements

Passion flower is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.comPassion flower is a popular supplement and tea that has been found very effective for helping to relieve both anxiety and insomnia. What passion flower does is to boost the level of sleep promoting GABA in the brain. Passion flower also helps to quiet brain activity, helping individuals relax, quiet the mind, and sleep better. In a 2004 study of 40 individuals with insomnia, passion flower proved to enhance sleep significantly more than the placebo. [35]

It has also been found to be highly effective for relieving anxiety, depression, and insomnia in women going through menopause. [36]

 

Infographic of the 12 best natural supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.com

7. Kava Kava 

Why kava is one of the best sleep supplements

Kava kava has been consumed by peoples of the South Pacific islands for hundreds of years, but is now becoming more popular in the West, as people have discovered that it has many of the same effects of alcohol, but potentially without many of the unwanted side effects of alcohol use. (There are even kava bars springing up in the U.S.!) It’s also one of the best sleep supplements. Kava use has been shown to be helpful with:

Kava Kava is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.com

  • Mood elevation. [37]
  • Decreased feelings of stress and anxiety. One study found that it significantly reduced anxiety-related symptoms within just one week of use. And a review of 11 studies found that kava was indeed effective in reducing anxiety. Some studies have even found that kava may be as effective as some prescription anti-anxiety medications. Kava is best used at night though, as it can dull alertness and cognitive performance. [38] [39] [40]
  • Improved sleep. Studies have shown that kava can improve the time it takes to fall asleep and have benefits on the quality of the sleep. [41] [42]

There is one potential drawback of kava consumption that still requires more research. Some studies have linked kava consumption with liver toxicity. Several countries have taken the pre-emptive step of taking kava off the market to be cautious, and even though it’s still available in the U.S., the FDA issued a statement regarding the “rare” potential for liver failure. Again, more research is needed to confirm whether kava is indeed toxic to the liver or not, but in the mean time, if you do use it, perhaps it’s best not to use it in high doses or for long periods of time. And if you already have poor liver function, it’s probably wise to avoid this one altogether.

 

8. CBD Oil 

Why CBD is one of the best sleep supplements

CBD Oil is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.comCannabidiol—CBD—is a non-psychoactive extract from cannabis plants (marijuana or hemp) that does not make one “stoned” but has many medicinal benefits. A rapidly accumulating body of scientific research now shows that CBD has benefits for conditions ranging from migraines to arthritis, to diabetes, to brain trauma, to PTSD, to anxiety, to cancer. [43] But it’s also one of the best sleep supplements.

It also has an excellent safety profile. And, for our purposes here, there is also research showing that it may enhance sleep. [44][45][46][47] (The only issue with CBD is that the research that used CBD for sleep enhancement used high doses, which can be quite expensive for many people).

 

9. Lemon Balm 

Why lemon balm is one of the best sleep supplements 

Lemon Balm is one of the best supplements for deep sleep | The Top 12 Natural Supplements For Deep Sleep, theenergyblueprint.comLemon balm is an amazing herb. It has so many science-backed benefits that it’s becoming hard to keep track of them all. Traditionally, lemon balm has been used to treat anxiety, but it’s also one of the best sleep supplements. Here are some of the benefits of lemon balm:

  • It’s particularly effective for easing hyperactivity in children[48]
  • Studies have also shown that it also enhances mood [49]
  • It has also been shown to decrease vigilant alertness, feelings of stress, subjective feelings of tension and anxiety, and decreased fatigue due to stress, while also increasing calmness. [50][51][52][53]
  • It’s also been found to significantly reduce insomnia, even for women during menopause. [54]

 

10. Valerian 

Why valerian is one of the best sleep supplements

Valerian root has been found to be a highly effective sleep aid supplement for persons with insomnia and other sleep disorders.

Valerian is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.comIn one recent double-blind study, valerian was found to yield nights of perfect sleep for 44% of participants and improved sleep for 89% of participants. [55]

Valerian And Lemon Balm Combination

Valerian root combined with lemon balm has proven to be highly effective in treating insomnia, more effective than either herb used alone. In a recent study of children with sleep problems, 81% of those who took an herbal combination of valerian and lemon balm reported sleeping much better than those who took a placebo. [56]

 

11. Magnesium 

Why magnesium is one of the best sleep supplements

Magnesium is involved in more than 300 metabolic reactions. It is essential for bone strength, a strong immune system, muscle contractions and a healthy nervous system, and it’s one of the best sleep supplements. Magnesium deficiency can result in neural over-excitation causing anxiety and restlessness and excess physical tension, insulin resistance, increased blood pressure, fatigue, irritability, poor cognitive function, lethargy, and sleep problems. It’s important to note that magnesium deficiency is very common in the U.S. and the many other developed countries. And there is indeed research showing that magnesium supplementation can improve sleep significantly.

One study published in the journal of Pharmacopsychiatry measured hormonal and electrical changes in the brain of older persons during sleep and found that magnesium supplementation improved both hormonal and electrical patterns in the brain during sleep. [57][58]

 

12. Chamomile

Why chamomile is one of the best sleep supplements

Chamomile is one of the best sleep supplements for deep sleep | The Top 12 Natural Sleep Supplements, theenergyblueprint.comChamomile has long been revered for enhancing relaxation and promoting sleep. Chamomile is rich in a flavonoid called apigenin that binds to benzodiazepine receptors in the brain.

  • In a recent 2016 study, women with postpartum depression who supplemented with chamomile experienced improved sleep and alleviated depression as well. [59]
  • Another double-blind study revealed that chamomile can help users moderately improve many aspects of sleep latency, night time awakenings, daytime functioning, and fatigue severity. [60]

 

The Most Powerful Sleep Supplement For Deep Sleep: Sleep Fuel

What if instead of messing around with a bunch of different herbs and supplements and testing whether that one works for you or not, you could skip all the guess work and just get the most powerful science-backed natural sleep supplements packed into one super-potent sleep supplement?

Sleep fuel is the top sleep supplement │ The Top 12 Natural sleep supplements, www.theenergyblueprint.com
Our top choice for most effective sleep supplement     (click the image above to purchase Sleep Fuel)

Ingredient list for sleep fuel the top sleep supplement │ The Top 12 Natural sleep supplements, www.theenergyblueprint.com

That’s why we decided to create our own sleep supplement that packs in the most powerful science-backed herbs and supplements that are proven to enhance sleep. So if you don’t want to have to buy 10 different supplements to enhance your sleep, and you’re looking for the most effective single sleep supplement, our Sleep Fuel supplement is simply the most powerful thing out there.

Sleep Fuel has a potent mix of concentrated extracts from the most powerful herbs for deep sleep — valerian, passion flower, lemon balm, and chamomile — all in one supplement. Plus it’s also got 5-HTP, L-theanine, PharmaGABA, B-6, and melatonin all in there.

 

 

It has a potent dose of almost all the best sleep supplements all packed into one supplement. Just pop two pills 30-60 minutes before bed and get ready for some seriously incredible sleep. Sleep Fuel gets absolutely amazing reviews from our members. Here’s one recent email we got from a person who tried it.

Sleep Fuel gets absolutely amazing reviews from our members. Here’s one recent email we got from a person who tried it.

Review of sleep fuel the top supplement for deep sleep │ The Top 12 Natural sleep supplements, www.theenergyblueprint.com

You will be blown away by how deep you’re sleeping after trying it.

You can get Sleep Fuel here.

 

Why These 12 Are The Best Sleep Supplements

Many of the supplements I’ve listed here have a highly synergistic effect. What’s important is you no longer have to rely on anti-histamine sleep aids and other prescription drugs to get sleepy at night to fall asleep more quickly or to stay asleep through the night. When you consider the overall effectiveness of the compound, plus the potential for side effects, going the route of using these compounds over prescription and over-the-counter drug-based sleep aids is an easy decision. Many people find that these natural supplements actually work better, and allow you to wake up refreshed, rejuvenated, and healthier (as opposed to the inevitable side effects from using drug-based sleep aids).

Below you’ll find links to my top choices of where to get each of these compounds (if you wish to buy them separately). But if you’d like to do things in a much more efficient and effective way, I highly recommend our “Sleep Fuel” supplement, which combines most of these ingredients into a single supplement. That way you get all the benefits in a cost-effective way, and without having to fiddle around with 10 different containers of pills, tinctures, and powders. Sleep Fuel gets amazing reviews from our members, and for good reason — it’s packed with the most effective science-backed natural ingredients to help you get to sleep faster and sleep deeper, while protecting and even benefitting your health (unlike potentially risky sleep meds).

I’ve put all these vitamins, herbs, and supplements into a convenient sleep supplement for deep sleep that combines the perfect dosage and combination of these herbs yield the best sleep you’ve ever experienced. You can get it here.

If you wish to purchase each of these supplements separately, here are the links to my recommended brands for each supplement:

  • 5-HTP
  • GABA (PharmaGABA is best)
  • L-theanine
  • Vitamin B6
  • Melatonin
  • Lemon Balm
  • Kava
  • CBD
  • Passion Flower
  • Valerian
  • Magnesium (glycinate or orotate are best choices, not the typical citrate)
  • Chamomile
  • Sleep Fuel (This is my top choice, which is not surprising because I am the one who formulated it! I made it in an effort to combine all the most effective, science-backed sleep supplements into just a couple pills. I’ve combined most of these compounds in this article into one supplement, so you don’t have to mess around with 10 different supplements. You can get the most potent synergistic mix of sleep boosting ingredients in a cost effective and efficient way that deepens your sleep without the hassle. You can get Sleep Fuel here).

There you have it — the top 12 natural science-backed sleep supplements. Now you are armed with the knowledge to take your sleep to new depths and your energy to new heights.

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If you want to learn more about how herbs can help you sleep. Listen to the podcast with Dr. Valentine Rose on how you can start using herbs for better health, sleep, and energy.

 

 

How To Treat Adrenal Fatigue – It’s Not What You Think!

Cover image of How To Treat Adrenal Fatigue with Dr. Bryan Walsh MD,www.theenergyblueprint.com

Do you have the symptoms of adrenal fatigue? Things like fatigue, sugar cravings, poor sleep, brain fog, and anxiety are some of the classic symptoms associated with adrenal fatigue.

If these symptoms sound all too familiar to you, then this podcast is a must-listen for you.

Dr. Bryan Walsh goes over why these symptoms often have nothing to do with “stress” (as most people claim), why the adrenals are usually not “fatigued,” what’s really causing your symptoms, and how to fix the problem and get your energy back.

Download or listen in iTunes here

Download on iTunes

 

 

 

Listen outside of iTunes

Watch

How To Treat Adrenal Fatigue – It’s Not What You Think! -Transcript

Ari Whitten: Hi everyone this is Ari and welcome back. I am here with Dr. Bryan Walsh who is an expert on the subject of adrenal fatigue and he has done a lot of work debunking a lot of myths in this area and helping with shedding light on what the true underlying factors are in adrenal fatigue.

I am a huge fan of his work. I have also purchased his course Metabolic Fitness Pro, which I am also a big fan of. He is a super smart guy and I am honored to be interviewing him.

I am excited to share him with you, so welcome Dr. Bryan Walsh.

Dr. Bryan Walsh: Thank you. It is a pleasure to be here.

Ari Whitten: Yeah, so can you just tell everybody a little bit about your background, what got you into this field and your origins?

Dr. Bryan Walsh: Yeah, I will try to keep it short when you ask that question and made me go back a little further. I started out, I have always been interested in the human body. I remember preteen actually asking my mom for money to order a nutrition book in the mail and would read this thing and she would drive me around – it was too early to even drive.

I have always been interested in nutrition and how the body works. I started out as a fitness professional, quite honestly, and then I added to that being a massage therapist. I was really interested in orthopedic work as it pertained to being a fitness professional.

What I found was a bunch of people – as it probably it happens with you – asking me about nutrition and supplements and all these things that were technically outside of my scope at the time. You know, I was a law-abiding citizen, and as a fitness professional and massage therapist out in California, I didn’t feel like I could. I knew a lot about nutrition, but I was I was a little afraid legally, and so I became a naturopathic physician. I went to a four-year school and it.

For those who don’t know, a naturopathic doctor or naturopathic physician is essentially a doctor of natural medicine. And it’s this huge umbrella we learned chiropractic adjustments, acupuncture, botanical medicine, nutrition courses, all the sciences too, of course. The first two years were mostly completely science. We learned drugs and, you know, how they are used in doses and diagnosis. Anyways, that was this huge umbrella for which everything fell underneath. We even learned physical therapy modalities and that was my calling because then I could talk to anybody about anything legally.

And since then, I think the short version is, integrative medicine and conventional medicine both do things very right and very wrong. And what I try to do, in this, in short, in summary, is bridge the best of both worlds.

What conventional medicine does really well, is science. We owe what we know about the human body and how it works to Western medicine. Honestly, in Western science.

On the other hand, conventional medicine sucks at finding, or even acknowledging, things like intestinal permeability, or that low cortisol is real and it’s not just Addison’s disease, or  Candida, or all these things that are very real. There are people suffering because of them, but they don’t look for them.

Integrative medicine, on the other hand, doesn’t really appreciate science as well as I think that they should. As a whole. They are great in considering food sensitivities, heavy metal toxicity, Candida, you know, all the things that I just mentioned. But they will overlook things like cancer, and they’ll do the fancy cool tests and not look for diabetes for example.

So, I try to combine the best of both. They both offer some amazing stuff, they both kind of suck at some things. I suck at a lot of things, honestly, but I try to bring the best of both, what they both offer because it’s not polar opposites. It’s not the yin and the yang, man, we are trying to achieve the same thing, just in different ways. And as much as I can, I try to bring those together.

What the old model of adrenal fatigue is

Ari Whitten: Nice. Really well explained, I like that, a lot. Let’s get into the meat of it, let’s talk about adrenal fatigue. I know, that this field has kind of undergone a lot of evolution of thought over the last decade or two.

Originally, James Wilson came out with this idea of adrenal fatigue and then you know we had Hans Selye’s kind of model of the alarm stage, and the exhaustion stage, and all that.

Can you talk a little bit about what the old model of adrenal fatigue is, and then maybe we’ll kind of segue into the new model.

Dr. Bryan Walsh: Yeah, I think you know Hans Selye was really the one who started it. And the work that he did – James Wilson was, I think that was probably the 80’s when he did he – so Hans Selye was much, much, much, much older.

Essentially, what he did was he coined, well he, I’ll tell you this, he brought forth the knowledge that we have about adrenal physiology, in ways that we just hadn’t known prior to his work, quite honestly.

What he did, was he created – based on his experiments with lab mice and lab rats he created – sort of this paradigm of the mammalian – because he wasn’t studying it on humans – stress response.

The way that he would sometimes stress them out was to have them swim until they couldn’t swim anymore or the variety of ways of stressing out mice apparently but he would stress them out.

What he would find is from baseline levels of cortisol, which was the primary hormone that he was interested in, that they would have this initial stress response and he called it the alarms phase.

Then if the stress continued, then the alarm phase would sort of come down and cortisol levels might come down and might be in back to the normal range, But then he would call that the resistance stage, where the body was still in a stressful situation and wasn’t responding the same way

Then if the stress continued cortisol may go quite low and then he called that the exhaustion phase, and that’s where they did not have the stress reserves that they did before,

Again, you know Hans Selye is still quoted so, so often especially in the alternative medicine space. And this whole paradigm then he talks about is it’s almost dogma and it’s great, we owe a great debt of gratitude for his work. quite honestly.

Why Hans Selye’s definition of cortisol levels and adrenal function is ”profoundly wrong”

But there was a paper by the guy that wrote the ”White zebras don’t get ulcers” book, Sapolsky. The guy is brilliant. And that guy’s just he’s phenomenal. But he was he co-authored a recent paper and they expressly stated – and this has been stated otherwise places as well – that Hans Selye taught us what we know, or knew, about glucocorticoids, or cortisol, or adrenal function. But based on modern science and used the phrase ”He was profoundly wrong” in terms of the things. That is not uncommon for science to not prove anything new, but disprove what we previously believed. I joke around about it, but I’m still kind of devastated that Pluto is no longer a planet because, for years, that’s what I believed, that’s what I was taught, and all of a sudden said, up no we’re not it’s not a planet. I’m like how could you how could you take the planet label away from a planet. But that just proves that we know something, we believe something, and then we just disprove it. We don’t prove something new.

And so what basically all this stuff and in the dogma that Selye proposed or is used as dogma now, is still quite present as you know. And this whole a model of adrenal fatigue that when James Wilson said when if somebody has low cortisol – which I’ll go on record as saying is absolutely true people can have low cortisol it’s not an autoimmune condition, it’s not pathology per se, they feel horrible, it sucks, I mean they are often depressed – there are some interesting studies on low cortisol and depression and mood disorders -, PTSD they have increased pain sensitivity, they have hypoglycemic tendencies, they can’t sleep, when they do wake up they feel they just they can’t even hit the snooze button, they don’t feel rested, they don’t feel recovered. It sucks, it’s real, that’s real.

But the causes of it aren’t, and this whole concept of adrenal fatigue that is going around is saying, well your adrenal and less than optimal – I’ll just quickly say too, I learned adrenal fatigue. I talked to my patients about adrenal fatigue. I even probably created a couple videos online ten years ago about adrenal fatigue and I’m embarrassed by it. Because I was taught what I was, I was teaching what I was taught, which was wrong, I shouldn’t have done that.

Ari Whitten: Yeah, like me and a thousand other people.

Dr. Bryan Walsh: Well yeah, because you learn it. You’re like well that’s cool, it makes sense, let me talk about people and I would see low cortisol and I would say this is adrenal fatigue. And the concept is that your adrenal glands are tired, they’re worn out, they’re shriveled up and they can’t make cortisol anymore.

So, you can see low cortisol on somebody on a test and the explanation is ”oh you have been under stress for a very long time” and I would have patients be like; ”well I don’t feel stressed out at all” like ”well listen you are, you have to be, your test is telling me that not only are you stressed now, but this stress has been going on for a very long time because your adrenal glands are worn out.”

That’s the story of adrenal fatigue but and  I’m sure you have plenty of questions but one of the first questions is, why is there not fatigue of any other organ?

Why is there not so in type 1 diabetics and late-stage type 2 diabetics, the pancreas no longer makes insulin why is that not called pancreatic fatigue. Why is a testicular hypogonadism the testes don’t make testosterone anymore called testicular fatigue, or ovarian fatigue, or pituitary fatigue, authority or any? There’s no such thing anywhere in medicine, anywhere.

But yet, these adrenal glands are these poor scapegoats ”oh you’ve been, so they’re worn out, they’re tired you’ve been stressed for a long time” and the thing is the science proves that no, that’s wrong. That Selye’s model was is incorrect, that he used the phrase ”profoundly wrong” when suppose, he wrote that article and the science says otherwise, but yet we still perpetuate this thing.

I can’t tell you how many patients literally a week probably in the neighborhood of five or so that will contact me saying ”I was either diagnosed with adrenal fatigue by another practitioner” or ”I’m pretty sure I have it, can you help me with my adrenal fatigue?”  No, because you don’t have adrenal fatigue, it’s not real.

Why adrenal fatigue has become a catch-all- diagnosis

Ari Whitten: Yeah, I mean, I feel it’s become a catch-all diagnosis where you found somebody’s complaining being tired. There are just a million alternative practitioners out there that are like oh it’s adrenal fatigue before they’ve even done any diagnostic tests and whether you have high cortisol or whether it’s low cortisol they’re like ”Hup, it’s adrenal fatigue.”

Like you said, have become the scapegoat for…

Dr. Bryan Walsh: Look at the symptoms, though, is in a bit, so mild depression, inability to concentrate, brain fog, pain, tired, food cravings, cravings for salt, cravings for sugar. You know, I’m like, well what condition doesn’t have those things? I mean, that’s, those are really diffuse symptoms that could also vaguely be hypothyroidism or be and that you know this is a catch-all too but chronic fatigue or fibromyalgia, all these different things, and you know, different autoimmune conditions and Candida fits a lot of those symptom profiles too. So it does, it has been a catch-all sort of wastebasket diagnosis for a lot of people.

The other thing is people. Like ”I’m stressed while my adrenals are probably shot.” No idea, yeah, you could be stressed and they could be high, I could be stressed and it could be normal, someone else could be stressed or not stressed and they are low. It has nothing to do, your perceived stress level has nothing to do with what your adrenal glands are actually doing.

The new model of adrenal fatigue

Ari Whitten: Yeah, absolutely. So the old model Hans Selye’s model, James Wilson’s model of the adrenal gland sort of getting stressed out, and worn out, and fatigued, and so they can’t produce enough cortisol. That’s profoundly wrong. What does the new model look like?

Dr. Bryan Walsh: Well there’s not any one place, that I think, that describes a new model, quite honestly. My story with this is, I wasn’t satisfied with my education, I wasn’t  satisfied with what I learned and had been taught, and it started with blood chemistry. And since I started learning about blood chemistry and the markers, where they come from, and what they mean and then I haven’t stopped, I just kept.

And then I would actually, I try to reach a dead end or already get bored with the topic, and I’d say ”Alright what else have I been taught that I should question?” and the adrenal fatigue came up, and vitamin D supplementation has come up, you know, gluten sensitivity has come up, Sibos come up all these different things but that’s how it started, and I just started  reading the literature, I started  looking at what real adrenal physiology is and what the modern scientific literature says about it, and so I can tell you and I’m – listen I don’t take credit for anything, so I would hate for someone to call this like the Walsh protocol, the Walsh model of adrenal something, rather this is just I’ve  just picked through  the literature a lot and come up with a couple things that I believe what low cortisol this so, I’ll say this again – low cortisol in patients is real. It does not have to be in an autoimmune condition, and they suffer from these symptoms.

The two things that I, it could be one, the other, or both:

#1 Functional Adrenal Insufficiency

Number one is what I’m going to call it a Functional Adrenal Insufficiency. Now I say functional because of medicine, conventional medicine says adrenal insufficiency, that’s when the adrenal glands can’t make cortisol. But they don’t consider some of the reasons, the functional reasons for this. It’s always some pathological condition so functional adrenal insufficiency is an adrenal gland that is unable to make cortisol for some reason.

Now, someone may say that that sounds just the same as adrenal fatigue. The adrenal glands aren’t wiped out, they’re not tired, they’re not overly taxed, there’s a reason why they’re not producing cortisol and in this model, the functional adrenal insufficiency, it could be things like mitochondrial dysfunction.

Why adrenal fatigue might be mitochondrial dysfunction

So to put it very simplistically. I don’t know the education level of your listeners but inside the cell, there’s a mitochondrion. Now, this is like high school biology for most people. The powerhouse of the cell makes ATP. But what needs to be known is there is, first of all, there’s this phrase or concept called adrenal dysfunction right now, and that’s conventional medicine is all over this to this is, this is real.

The mitochondria, this is really fascinating, the mitochondria take cholesterol. Everybody knows cholesterol into the mitochondria and the first step to turning cholesterol into cortisol occurs inside the mitochondria, into pregnenolone. When that happens, pregnenolone leaves the mitochondria, heads over to this thing called the endoplasmic reticulum does a few other enzymatic changes, the byproduct that heads back to the mitochondria and then the last step that turns it into cortisol, and then it’s released.

So, if nobody followed that whole thing, the bottom line is: you have to have healthy mitochondria to make cortisol and there’s this concept called mitochondrial dysfunction which is very real. There’s also something called endoplasmic reticulum stress, which is another organelle dysfunction. That too is very real, and mitochondria-endoplasmic reticulum tends to hang out really really close to each other inside of cells. So, if you have one dysfunction, you’d then have both.

So, if someone has too much oxidative stress, free radicals, mitochondrial dysfunction, it’s this is too much to explain, but NADPH deficiency, things inside the cell that are not working properly, you can’t make optimal amounts of cortisol.

Another big one today, and I have no idea how much this is actually impacting people, is the exposure to certain toxic chemicals. Certain toxic chemicals are absolutely known to inhibit every single enzyme in turning cholesterol into cortisol, and to any of the sex hormones estrogen, testosterone, doesn’t matter, but you can find a list of like 15 common different things from heavy metals, to pesticides, fungicides, and even some pharmaceutical medications that block.

I’ll just mention the enzyme 3β-Hydroxysteroid dehydrogenase which is one of the many enzymes to turn cholesterol into cortisol. Arsenic, phthalates, PCBs, dioxins they help block this enzyme. So if you have exposure to these things, you may not be making cortisol. Not because your adrenal glands are tired or wiped out, or you’ve been stressed for a really long time. It could be too much oxidative stress, it could be the mitochondria aren’t working properly or a combination. It could be nutrient deficiency that just to run the processes inside the mitochondria – and I’ll go into as much detail this as you want –

Ari Whitten: You’re doing great, I love that.

Dr. Bryan Walsh: But the process is inside the mitochondria, just to function properly, people are familiar with the Kreb cycle, maybe you’ve heard of the electron transport chain. The amount of nutrients, and when I say nutrients, I mean vitamins and minerals required to run those processes, is intense. There are so many different nutrients that if you’re deficient in some of these nutrients, the mitochondria doesn’t work. If you have too many oxidative stress or free radicals, the mitochondria don’t work. If you have certain toxic exposures, you can’t turn cortisol, into I’m sorry cholesterol into cortisol.

This this is all under that heading of what I would call a functional adrenal insufficiency. That you’re not making cortisol and it’s for some dis, not pathology, not disease process, but nutrient deficiency, too much oxidative stress, mitochondria, to something inside the adrenal glands where, if provided, they would be able to make cortisol but they are not. It’s not fatigue, it’s not, they are too tired, they’re not shriveled up, and it certainly doesn’t take two years to rebuild the adrenal glands – which I’ve heard some educators teach other practitioners – which is just bogus. It’s just totally wrong. give them the right nutrients, if that was the problem, they’ll start making cortisol in a couple of weeks. I mean so that’s one of them, okay.

Low cortisol is real

Ari Whitten: Let me just, I’d like to give the overarching paradigm. Low cortisol is real, the issue with the adrenals not being able to pump out enough cortisol is a real problem that manifests and very real symptoms. The issue is, it’s not coming from them being fatigued from stress and not being able to do it, it’s these other causes that are inhibiting them from.

Dr. Bryan Walsh: I will tell you, it may have nothing to do with stress at all. Under that premise when you think about it, it may have nothing to do with stress. Nutrient deficiency has nothing to do with stress, that’s just maybe not eating the right foods, multivitamins, poor soils, and not digesting/absorbing them. It has nothing to do with being chronically stressed.

I won’t get into this, too many, to make cortisol you make a lot of reactive oxygen species or free radicals in the process. Theoretically, someone could have been under a considerable stress making a lot of cortisol but therefore creating a lot of free radicals which then damage the cell, damage the mitochondria, if that makes sense.

So technically, that could be accurate but no, very few of those things if anything it may not be due to stress.

How toxin exposure might be the cause of adrenal fatigue

Ari Whitten: Gotcha, okay.

Dr. Bryan Walsh: Toxin exposure is not due to stress, you’re not stressed out.

Ari Whitten: Yeah, on that note, I actually recall a really interesting study that you had posted on your facebook, maybe a month or two ago. It was, I think, it was done in rats, and they were showing that glyphosate was inhibiting cortisol production. You were kind of like, well is it, you know the adrenal glands getting fatigued, but are now from stress, or is it, you know, just that you have this toxin that’s preventing the adrenals from producing cortisol?

Dr. Bryan Walsh: Yeah, but here’s the point, if you haven’t had a chance to actually read that study. Here was the really potent, so that’s one thing, so that roundup might be causing this low cortisol in people but here’s the thing, man, this is. The real kicker about that study was, that at doses far below what the EPA, and I think the World Health Organization, considered to be as and it’s known as an endocrine disruptor. When we think of endocrine disruption, we think of estrogen and testosterone and sex hormones, but at a level well below that causes issues with those other hormones. It was causing cortisol suppression, so what this study was basically saying, is small amounts of this – well under the radar of what people consider to be safe – is causing cortisol suppression in rats

Then my question was, well yeah with the exposure that we’re getting. I mean, I live in sort of farm country. Who knows with the farmers around me are – and we have well water – like, who knows what people are spraying, am I getting small amounts of this stuff, who knows? And at levels far below what’s considered to be safe by government agencies, so that’s what was really compelling about it. It’s the only study that I was so happy to find, that was the only study that I know of, that’s looked at that. It’s pretty scary stuff, but.

Ari Whitten: Yeah, sure, interesting. So, I don’t want to digress too much, but there’s one thing  that I see skeptics, like science sceptics, do often and there’s, I think, an unfortunate tendency of science, you know, people who identify themselves as skeptics to want to minimize all of the fear around different toxins, and they seem to, it seems to be popular among that crew to want to prove that all of these toxins are actually really safe and totally harmless, and you know all that kind of stuff and I don’t know if you saw recently, there was like a TV show where some guy did a stunt where he drank a thing of glyphosate to prove how safe it was, and one of the things, the way that they make arguments often is based on the LD50 buttons. And so they say, ”oh you know the LD50 of glyphosate is this much, and you know, here, it’s this much for caffeine, and it’s as much for table salt, and it’s as much for water, and for you know, whatever else, therefore, glyphosate is just as safe as table salt and water.”

Dr. Bryan Walsh: Right.

Ari Whitten: And I think that argument is just so deeply flawed, because you LD50 is one thing, the amount of substance it takes to kill you, and then the amount of substance it takes to start disrupting some important hormones and physiology that can resolve in some pretty nasty symptoms, is a whole other thing.

Dr. Bryan Walsh: Yeah, no, I know you don’t want to digress. I just put in I can’t even tell how many hours went into this, but I did an eight-hour presentation for health practitioners on this topic. I hate the topic, but of detoxification. And I will tell you that they don’t have this, they use the LD50 acutely, right? What’s the LD50 of that over 20 years? how, many people would die from exposure to a certain dose of that over 20, or 30, or 40 years? That’s still an LD50 if they’re dying from it. It’s just not right now, he doesn’t drink it and keel over. Well, that’s a different man. Yeah, and there’s there’s plenty of studies that suggest first of all, that a synergistic effect between multiple things at a lower dose is damaging to is that there’s a latent effect of these things that these. In fact, in the world of toxicology, the big phrase is the dose makes the poison. And that’s what that’s what the skeptics will say. They’ll say, ”well, you know, water is toxic if you drink enough of it because you’ll die from it.” Well, great argument. But that there’s evidence in studies that there’s a latency effect, that you can get exposed today and literally not exhibit symptoms for much, much, much later.

 

Just to give you one, there’s a case study published case study of a woman, a scientist, in a lab, that was exposed to a fairly high dose of mercury. Didn’t exhibit symptoms and in the study, I want to say was like at least a hundred eighty days later, 256 days or something like that. But, then, all of a sudden hundreds of days later, started having symptoms of mercury poisoning. But she had had this, like, months, and months, and months before, and the researcher said, ”maybe the dose doesn’t make the poison that it actually has to do with this latency effect.”

The the other thing I want to say is – and you can look into this later for the interest of time – this blew my mind, blew my mind when I read about it, it’s very new and it’s called a Non-monotonic dose-response. In short, what the studies on the non-monotonic dose-response suggest – and this dude, like, blew my mind – is that low doses of a given chemical, are literally just as physiologically damaging and toxic as high doses.

This is brand new, and the studies – again in the interest of time we can’t get into this – but the studies on this – and they’re all new from like 2012 and above, basically say that in the world of toxicology, we thought that this might happen, but we didn’t really believe it. Now, not only is it plausible but it’s likely happening.

The class of toxins that this happens to be occurring in and they say this is in the endocrine disruptors. It doesn’t seem to be with heavy metals, it doesn’t seem to be with a number of different other drugs, or toxins, but specifically endocrine disruptors. And you should see these curves. It’s, they usually, they use it an s-shaped curve to come up with the, what they call the non-observable adverse effect level, and then there’s a sort of S-curve and it gets more and more toxic. What they found is that it is a U and that low doses are just as physiologically damaging as high doses. This is brand new like I don’t get my mind blown very often but I read this, and I was like holy care, this is a game-changer dude. And the dose doesn’t make the poison. Anybody that says that is, at this point because the studies are out there, is just ignorant.

Ari Whitten: Wow, that’s crazy.

Dr. Bryan Walsh: It’s horrible.

#2 Adrenal Suppression or Adrenal Inhibition

Ari Whitten: So far we got low cortisol was real, the main area we’ve talked about so far is functional adrenal insufficiency. Things like mitochondrial dysfunction, endoplasmic reticulum, stress, toxins, nutrient deficiencies. So that’s one what’s, the other big thing that is going on?

Dr. Bryan Walsh: Well, I saved the other one for last because I actually think this is what’s going on more often. Now, like I said it could be the functional adrenal insufficiency, it could be this one which I mentioned or it could be a combination, quite honestly,

But this other one is what I’ll just loosely call adrenal suppression or adrenal inhibition. Which is essentially the same thing, and this is the body intentionally telling, if you will, the adrenal glands not to produce or release cortisol. Saying, ”we don’t want cortisol right now, I know you can make it if you want to, I know you’re still super strong and potent enough to make cortisol, but right now we actually want low cortisol.” Which is – it may sound strange – but it’s the body. The body does that all the time. If you get a fever the body sequester’s iron it says, ”Listen, if you have any iron floating around, let’s get rid of that, because if the microbe that’s infecting you right now has iron, it will be able to proliferate and replicate better. So, let’s get rid of all the iron.” It intentionally lowers your iron availability, just to starve, if you will, the microbe.

I personally believe that it has the ability to suppress vitamin D. So maybe that’s the reason why we’re seeing all this low vitamin D. It’s not uncommon for the body to inhibit it. If you go into a hypocaloric state, if somebody’s dieting for a competition, for example, it suppresses thyroid on purpose. It’s you’re not eating as much, let’s slow down the metabolic rate so that you don’t burn up too fast. It does it, does these things intentionally all the time.

So, why is it so strange that the body would, in certain circumstances, intentionally want low cortisol.

I will tell you that in my personal experience. I think that that is a more common cause of low cortisol than is the other one that we talked about. Though that’s entirely possible, just super hard to measure. This adrenal suppression or adrenal inhibition, the body intentionally lowering, is suppressing the adrenal glands from producing cortisol.

How infections might cause adrenal suppression

Ari Whitten: Okay, awesome. So, you mentioned one potential reason for that, which is a chronic infection of some kind, or where the body is trying to sequester iron for example.

Dr. Bryan Walsh: Oh, no, that was it that was a separate example. But infection will do that, though. And regarding the adrenal glands, yes, the infection is probably one of the most..

I always say this, in immune-related stuff, so infection of a variety of different types, low-grade chronic inflammation, that a number of what are called cytokines which are simply immune system molecules are released that literally suppress cortisol production. I mean these, they have been shown to be potent suppressors of cortisol things like, tumor necrosis factor alpha, and over time interleukin-6, and there are these things released by neutrophils called defensins – which you can kind of figure out what they do – but there is an immune cell and one of the things  that do is, it suppresses cortisol. Now, transforming growth factor-beta is a major as a major suppressor of cortisol.

So, these are all immune molecules…

Ari Whitten: All of that kind of lumped together with inflammation or infections…

Dr. Bryan Walsh: Yeah, those are two separate things. You can be infected and not inflamed, you can be inflamed and not infected, to some degree.

And the other one also has to do with infection. It’s kind of a long word abbreviated as LPS, but lipopolysaccharides. Lipopolysaccharides, the where our exposure would come from with that, would be unfriendly bacteria, we will call them, in the gut.

Ari Whitten: So, not dysbiosis?

Dr. Bryan Walsh: You can call it dysbiosis, certain bacteria typically the gram-negative bacteria. They produce toxins and this is considered to be an endogenously produced toxin because it’s something within you that’s making it. But if they make it, and you have what’s called intestinal permeability, or leaky gut, then these lipopolysaccharides or LPS can go systemic into your body and lipopolysaccharides are a potent inhibitor of cortisol, chronically.

And, here’s, – I’ll just give it a quick caveat to this – most of the studies looking at these things, look at it acutely.

Interleukin-6 actually increases cortisol levels acutely. That’s the difference, lipopolysaccharides increase cortisol levels acutely, but none of us are going to get an acute dose of lipopolysaccharides. We either have dysbiosis and leaky gut and therefore have this leak of chronic lipopolysaccharides into our system, or we don’t have it at all. We don’t have like, ”wham here’s an injection of lipopolysaccharides,” it doesn’t happen that way,

Ari Whitten: Also, outside of acute food poisoning?

Dr. Bryan Walsh: Well, yeah, possibly. Yeah, yeah, possibly, or if your subject of a laboratory

experiment when they injected you with lipopolysaccharides. But no. So, lipopolysaccharides acutely increase cortisol production but chronically suppress it. That’s another one. So somebody could have dysbiosis with intestinal permeability, circulating lipopolysaccharides and that’s causing a blunted cortisol response.

And and I’ll tell you what, lipopolysaccharides, infection, inflammation those are not adrenal fatigue. In addition to the fact that you can go straight from normal – to go back to Hans Selye -you could have normal cortisol and have an infection of some kind, go straight to low cortisol, done. There’s no alarm phase, resistance phase, exhaustion. You went straight from normal to   ”exhaustion” and it has nothing to do with this chronic stress and you are stressed and you could be stressed have high cortisol, and stressed for life and have high cortisol that you just have this really efficient system.

So going back to Hans Selye, that’s why it’s wrong. You can go straight into low cortisol just by getting an infection.

How leaky gut is linked to adrenal fatigue

Ari Whitten: Interesting. Okay, so inflammation, infections, LPS, and then that LPS goes along with leaky gut and gut dysbiosis.

Dr. Bryan Walsh: Well, it would. It’s present with dysbiosis and will only go systemic if you have intestinal permeability. Otherwise, it just stays in the gastrointestinal tract by large.

Ari Whitten: And is that, do you think this, does leaky gut commonly go with dysbiosis?

Dr. Bryan Walsh: Yeah, well yes, yes, yes, yes the studies are pretty clear on that too. that that if a real quick way to intestinal permeability is some kind of infection in the first place. It’s not the only way – like dehydration while exercising supposedly causes it, there’s a variety of things that does – but yes, infection is considered to be a quick way to intestinal permeability.

Chronic and stealth infections

Ari Whitten: Okay, and real quick on the subject of infections. More and more I’m seeing people talk about chronic infections were hidden infections, things like that. what what’s your take on, is this is just a common thing? Do you think that there’s quote unquote…

Dr. Bryan Walsh: Well I don’t know, I think the concept of a hidden infection is sexy. I mean, that’s of course, ”Uh, this stealth infection that we have to find” and it also kind of lets us off the hook, because if we can’t find it, but say it’s there, then we could treat. I don’t know.

So, with that said, viral infections and when you say hidden infections, I typically think of you know the lyme community, and some of the co-infections that occur with lyme, that are really hard to identify. But viruses which are not sexy. They were like the original stealth organism when you think about it. That these things are so old they don’t even have a cell wall themselves, to protect themselves, they have to infect another host, a cell and replicate within that cell until that cell dies. And like cockroaches, they all scurry to somewhere else.

Anybody that’s had chickenpox has a stealth infection if that makes sense, and some people it will manifest as shingles, and other people it will stay stealth all the time, and the people that it develops in, the shingles, are the people that have usually some kind of stress response. And it’s so, so insane that their immune system gets so suppressed that it can no longer keep that particular infection at bay.

So, I like your question. I personally think that there are quite a few people that have a chronic infection of some kind. I’m not going to say it a stealth infection, or a hidden infection, but it’s definitely some kind of usually a chronic viral infection and I’ll tell you, the part of the reason why I say this, is the number of people, today, that we run a blood chemistry on, that has a…

Anyways, so on our blood chemistry panel the number of people today that have low normal white blood cells, which is typically a marker, the way that we use that most often, is that there’s some chronic insult to the immune system. And it could be an autoimmune condition which could be argued, it’s a chronic insult, it could be a chronic infection of some kind which is a chronic insult, and that the immune system is not, it just lacks the robustness that it’s sort of losing this long-standing fight.

I can tell you that out of 10 average patients, probably five or six have low normal white blood cells. We don’t test for all these different hidden or stealth infections but the question is. why is our white blood cells low in so many people today? And I would not be surprised if there’s virus, viral infections that are – I don’t call them hidden but latent – there and the immune system like I mentioned with chickenpox and shingles, viruses can exist inside of us but our immune system can keep it at bay, so that it doesn’t go wild.

But then the question is, at what point, is there a point between chickenpox, and full-blown shingles, where it doesn’t manifest as shingles, but it still is impacting the body, and therefore maybe cortisol? If that makes sense.

So we don’t get full blown viral infections or the manifestations of them, but it’s rearing its head enough to cause low cortisol. So to answer your question in a long-winded way is: they do think there’s a lot of what I’ll call subclinical chronic low-grade infections, that are occurring in people and that very often are leading to low cortisol.

How low cortisol levels can be linked with cancer

Ari Whitten: Gotcha. Okay, so is there anything else that you lump into the category of are inhibition?

Dr. Bryan Walsh: Those, that’s the big one, is that it’s being inhibited, that the body, when I say inhibition, the body is intentionally suppressing its ability to synthesize and release cortisol. It wants cortisol to be low.

I don’t want to freak people out, but cancer would be a great example of this too that certain things are going on immunologically with cancer, that the body would likely want little cortisol. Same thing with viral infections.

Same thing if you get a fever. Someone gets a fever, wants to run adrenal panel I’d be willing to bet that when you’re in the heat of that fever, that you will have low cortisol. Because the immune system wants you to have low cortisol so that it can stimulate certain cells and inhibit other ones. So, no, those are the main ones just an infection, inflammation of some kind, chronic inflammation, lipopolysaccharides, dysbiosis, those be the main things in everything.

Ari Whitten: Okay, so we got these two causes adrenal inhibition you said, you think is the more common one.

Dr. Bryan Walsh: I think, yeah, as far as I can tell.

Ari Whitten: But at the same time. I mean, given what you talked about with different exposures of toxins and how they disrupt how the other endocrine disruptors and how common exposure to those things are, as well as common how common nutrient deficiencies are. I mean, I would have to imagine that those are players at least in the background.

Dr. Bryan Walsh: Yeah, I don’t think. It doesn’t help. I don’t know how. My suspicion is somebody would have to be pretty nutrient deficient, to cause low cortisol. To put it another way, okay, what are other people that have low cortisol due to inhibition? That have a subclinical nutrient deficiency that it’s contributing to it, but not. But they would not have low cortisol if that was the only reason. So, I think those are contributors, more than causative factors.

I think that the toxin issue, Again I think it’d have to be a fairly significant toxic exposure to cause clinically low cortisol. But, in somebody where it’s suppressed, I would have guessed that it’s it’s an additive effect, I think that it’s contributing to them.

Ari Whitten: okay so let’s just as a thought experiment. Let’s say you take somebody and you subject them to chronic low dose LPS exposure. You know they have gut dysbiosis and leaky gut and so they’re chronically getting this LPS leaking into the bloodstream, and then maybe they also have some kind of hidden infection suppressing cortisol and just those two causes alone, or even one of those alone, if that’s inhibiting cortisol production and lowering cortisol level is that enough to explain all of the symptoms that we see in adrenal fatigue?

Dr. Bryan Walsh: Yeah.

Ari Whitten: Okay, so just having that low cortisol will result in all of those symptoms we see that people commonly associated with adrenal fatigue.

Dr. Bryan Walsh: Yeah.

Ari Whitten: Wow.

How low cortisol can be linked to PTSD and depression

Dr. Bryan Walsh: Yeah, in fact, I’ll tell you there was one study – and I don’t have any of these things in front of me – there was a study, I forget how many subjects were in it, I forget the title of it, and I forget the journal at the moment. Though, I could send it to you after we’re done

Basically, gosh, I wish I remember it was something along the line, it looked at people who have mood disorders, and it said it was it was PTSD, depression, and there was another one involved. But basically, what they did was, they said, all these neurological mood based conditions. Is it low cortisol in the first place?

So what they did was they looked at cortisol levels in all these patients and it was low. And what they did was they gave they gave hydrocortisone, which is synthetic pharmaceutical cortisol, and I forget how many people improved. But you understand this, they said it reversed it reversed PTSD, which means that that’s code for a cure.

Well, I mean they can’t say it. They reversed PTSD, they reversed depression, they reversed these mood disorders. And when they identified low cortisol, and they gave synthetic cortisone which is their way of doing, and that’s fine, I think we’d like to try to correct it. They gave it, in the majority of the people in the study their symptoms improved, and some of them even were cured is basically what they said.

What they went on to say that perhaps, as the in the psychiatric industry we shouldn’t be moving to drugs first, but instead because of the prevalence of low cortisol with mood disorders and the fact that we can treat low cortisol and correct these mood disorders maybe we shouldn’t be giving these things like, Prozac and mood drugs first.

So, when you ask, are these associated with low cortisol? Absolutely, depression, mood disorders, anxiety, low blood sugar symptoms, can’t sleep. There’s an associate of cortisol in melatonin and substance p. They have increased pain perception, man, like just because of low cortisol. It’s very real symptoms, and it is because of low cortisol.

Ari Whitten: Wow, powerful stuff. Okay so, so we got all the paradigms here now of what’s really going on. What’s the real physiology behind a lot of these symptoms that people commonly associate with adrenal fatigue? Can you take me through a couple practical examples of what this would look like as far as a treatment plan and understanding that, of course, you’re going to do diagnostic tests, and you’re going to figure out what’s probably going on in that specific individual, before you start attacking a treatment strategy. But maybe just give a couple typical cases, and one of the layers of strategies that you address, maybe the order that you go about doing things.

What supplements you can use to balance your cortisol levels

Dr. Bryan Walsh: Well it’s that’s actually a bigger question. What I can tell you, I’ll answer the question simply.

First of all, that in somebody that has low cortisol that’s been identified by a lab.One of the things that I’ve found to be most effective is giving botanicals, or herbal compounds that are typically the kinds that you would take when you’re  getting sick so like, echinacea, goldenseal,  any of the medicinal mushrooms maitake, shiitake, reishi, those kind of things lemon balm or was also known as melissa officinalis.

And this is an interesting one is licorice root, which is historically been used for low cortisol in the first place. One of its actions it has, it has many actions, but one has to wonder if this is why it’s been so effective, is one of these actions is it increases the half-life, I should say decreases the half-life of cortisol. So, the cortisol you have exists longer. It also is antiviral, which is interesting because that’s the cause of low cortisol and it also tends to stimulate the – was not going to get into this – but the Th1 side of, it’s a Th1 stimulating botanical, which is typically what you want.

And so curiously, not only does it impact cortisol, it’s a more detailed, it’s an aldosterone antagonist so it increases sodium absorption, water absorption, can increase somebody with low cortisol blood pressure, and their blood pressure is typically really low. They usually get that orthostatic hypotension where they get lightheaded if they stand up too quickly, for example. And licorice root kind of combats that to some degree at any rate.

So, if somebody has low cortisol and they know that on a test, and that’s all the information that they have, what I would consider trying, is loading up with those types of botanicals; echinacea, goldenseal, Oregon grape or mahonia, licorice root. I mentioned the mushrooms are good usually in a tincture or extract form, licorice root can be very good. If something truly has low cortisol, they’re gonna have low blood pressure too. The big concern with licorice is that it’s going to raise your blood pressure. But in a truly low cortisol person, they have low blood pressure

And those will tend to, I have seen that normalized cortisol without having to take any adaptogens. Which are the botanicals? Things like Rhodiola, and Eleuthero caucus, and ashwagandha, and all these ginseng, is all these things that are supposed to help our body adapt.

I did some research on these, and how those adaptogens work it’s very interesting. They don’t work on the adrenal glands it turns out. But by those immune stimulating botanicals, I have seen cortisol regulate itself, normalize itself very, very quickly without taking any adrenal glandulars, any adaptogens, or any of those types of things

I think that’s the most powerful and quickest thing that somebody could find.

Ari Whitten: Okay. Medicinal mushrooms, lemon balm, licorice, echinacea, and goldenseal. Was there any anything else you want to lump into that?

Dr. Bryan Walsh: Anything that’s that supports Th1 side of things. And somebody can go online and research Th1. It’s either Th1 stimulating botanicals, or th2 inhibiting botanicals, or compounds. Those are the same thing. This is a popular topic right now, so you can go online and find some pretty long lists of some of these things

There are certain probiotics that will tend to stimulate one side of it or the other. I haven’t used those very much with low cortisol cases, though I think it’d be really interesting to do. But basically that’s the goal is to try to stimulate the Th1 side of things as much as possible and those mushrooms or good licorice root is fantastic, echinacea, goldenseal, berberine is found in  Golden Seal as well as Oregon grape or mahonia. So, berberine seems to be effective.

Ari Whitten: Gotcha, so as far as mentioned actually, I want to digress for a minute. You mentioned something about the adaptogens that they don’t really work on the adrenal glands. How do they work?

Dr. Bryan Walsh: there’s just, listen, and it was one study – it wasn’t the best-done study – but it’s really interesting. They were suggesting, that adaptogens allowed the other cells to respond to cortisol better, was basically what it was. So, it may not actually impact cortisol levels because adaptogens historically were used to help us adapt to stress, which when we didn’t have lab testing, which made us meant made us feel better, right

So, and there’s this whole thing of cortisol receptor resistance which is you’ve heard of insulin resistance as a whole other thing too. So these adaptogens were used for millennia to try to help us adapt to stressful times, and it would make people symptomatically feel better but there wasn’t any lab test to prove, and I have not seen adaptogens help improve cortisol levels on lab tests. I just haven’t. If there are practitioners that have, I’d love to see that and, I’m not questioning them but I’m saying, I just haven’t seen that very much. Interestingly is perhaps and this would make sense, maybe adaptogens don’t impact the adrenal glands but allow our other cells to respond to cortisol more normally and therefore we feel like we’re responding better.

So, all the original work, they didn’t have lab tests to say adaptogens raise or lower cortisol. They help us adapt to stress, whether it was a lot of stress or too little stress, or we had a hyper or hypo stress response, it was said that they helped but maybe that’s the mechanism, it’s actually helping all the other cells of the body respond to stress and or cortisol and or epinephrine better. Very, very fascinating, kind of 180 but interesting stuff.

Ari Whitten: Interesting. Ok so the first thing that you’ll typically do with someone, is that group of botanicals and you said you’ve seen that normalize in a month.

Dr. Bryan Walsh: I’ve seen cortisol go from tanked to completely, normal rhythm. The cortisol levels.

Ari Whitten: Wow. Ok so, let’s say that it in that person that you did that with, they still have symptoms. Maybe their cortisol hasn’t normalized yet and they still kind of feel maybe what they call adrenal fatigueie, and they feel in some of those symptoms what might the next step be,

Dr. Bryan Walsh: So, fantastic question. Here’s the thing. I would highly recommend lab testing. And here’s a great example. Let’s say somebody had low cortisol, they took some immune enhancing botanicals and their next cortisol came back as normal but they still had those symptoms.

So, then what that’s saying is that those symptoms are not real and probably not related to their cortisol levels. If their cortisol came up and that’s now normal, then all those symptoms it didn’t have to do with low cortisol, and then it’s something else entirely.

Maybe it’s low thyroid. Low thyroid and low cortisol have many same symptoms, not all, but many. Different hormone imbalances can, like I said different types of infections, so like Candida has many of the same symptoms as low cortisol; brain fog and fatigue, and you can get some achiness associated with that. So at that point, I would just want to look, food sensitivities, quite honestly. Food sensitivities can have many of the same symptoms as low cortisol as well.

So, ultimately, and I know you already know this, you need to take a sort of a real wide angle lens with this person. You don’t just want to only look at cortisol levels and only treat cortisol levels and rarely do we, in fact, it’s we usually start with a blood chemistry test. Look at blood sugar, thyroid, and all the things you can find out a blood chemistry test. But then need to start looking for, you have to look for something else if their cortisol levels are normal but they still have symptoms, something else is going on that you haven’t yet found. It could be food sensitivities, or Candida like I said, or thyroid, a number of different things.

If they take those things and their cortisol doesn’t come back up, then honestly from the research that I’ve done, it’s either suppression or a functional adrenal insufficiency, so then you really do need to consider that maybe they have massive amounts of oxidative stress, or maybe I will tell you at some point – and a medical doctor may need to get involved for this, although people can find places to run this on their own – is to run a hormone called ACTH or adrenocorticotropic releasing hormone.

ACTH – without getting into the details – is a pituitary hormone that tells the adrenal glands to release cortisol. If you were to run ACTH, it can tell you if the problem is in the adrenal glands, or if the problem is higher up.

So, just to paint a real quick picture. If someone has low cortisol, and they have normal or high ACTH then that suggests the problem is in the adrenal glands, that the pituitary glands are saying no for some reason, and either the botanicals that you gave weren’t enough to overcome the immune system or there’s excess oxidative stress or mitochondrial dysfunction, that’s  higher order. So that’s then the dysfunction is in the adrenal gland.

On the other hand, if you have somebody that has low cortisol and low normal or low ACTH then what this is saying is, their adrenal glands are not producing cortisol because they’re not being told to. The body, the adrenal glands, aren’t doing but the whole body is not even trying to do it. If ACTH is low, now you’re looking at something higher up in the pituitary, and the hypothalamus, and the brain. Something. And that’s a that’s a bigger issue, quite honestly. And one that an endocrinologist might be able to walk somebody through at that point. But if somebody has long-standing low cortisol that’s not being resolved in anything, I would suggest getting ACTH run because that will tell you if it’s the adrenal gland that’s causing the problem or if it’s something else. And if it’s something else, that’s a whole other whole other bag.

When to consider functional adrenal insufficiency vs. environmental exposures

Ari Whitten: Okay, at what point would you start considering the possibility that it’s it’s functional adrenal insufficiency and you know maybe it’s a result of toxin exposure?

Dr. Bryan Walsh: That’s  a really good question. There are some decent labs right now that look at toxin exposures – and I don’t want to get too deeply into that – of these panels that are looking at toxin exposure if they come back as positive, they’re positive. You have exposure to those chemicals. If they come back as negative it means nothing. And that’s because there’s there are some pretty awesome studies on this. That’s because if there is a bit well – I put it this way – people have tested negative in urine for a chemical, in stool, and in blood. But positive and sweat. This is the same person.

Ari Whitten: Interesting.

Dr. Bryan Walsh: So in that, that speaks to its storage and how it’s not being it’s not being liberated, unless the body is asking it to via sweat, for example. When the body heats up, you get some lye pollicis, and it gets liberated, and then it gets excreted.

But there are a couple studies, that they took about 20 people and they didn’t have, it was negative in urine, blood, and stool, and positive in sweat. And so, that to say it again, if somebody runs on of these tests that are usually urine there’s stool, there’s urine or blood-based. If they come back negative, that doesn’t mean you don’t have exposure to that chemical

So the long answer to your question is, additional testing could be very helpful. The short answer I will tell you is if you see a good practitioner, in general. They’re going to be working on you in nutrients efficiency, they’re going to have you follow, they’re going to be paying attention to your diet, and having to eat a good diet probably taking some kind of multivitamin, and dealing with possible nutrient insufficiencies. They’re probably going to be addressing excess free radicals and oxidative stress, just as a consequence of their program that they’re putting you on.Hopefully, if they’re good practitioners, if that makes sense.

How to address oxidative stress

Ari Whitten: And just I’m not to digress, but can you mention a couple strategies that you mean as far as addressing oxidative stress?

Dr. Bryan Walsh: Nutrients efficiency, will combat oxidative stress by itself as well as antioxidants. And I don’t mean supplemental if somebody falls if somebody is not following a decent diet. The following a good diet will combat oxidative stress. Their nutrient insufficiencies which both kind of work on each other

A good program is going to have somebody exercising, and therefore sweating, and therefore probably getting rid of a similar toxic load. A good practitioner is probably going to talk to the patient and say, ”listen, toxins are horrible. You need to clean up your life, you need to stop using the same cosmetics that you’ve been using, toiletries, cleaning products, and some of those types of things

So to answer your question. A good practitioner is going to be addressing those things indirectly, no matter what. Just because of you cannot be healthy if you have exposure to toxins, you cannot be healthy if you have nutrients insufficiencies. So, a good program is going to say, Mr. or Mrs. Patient, here’s all the things that you need to be doing to address, that’s only going to serve to help whatever your signs and symptoms are if that makes sense.

Ari Whitten: Yeah.

Dr. Bryan Walsh: So, the only caveat to that is, one could run a panel on for oxidative stress, and one could run a panel for toxic exposure. If they really wanted some ”hard data black and white” on if they had issues with these things or not. That said, neither of those tests are perfect but you can have oxidative stress that won’t show up on an ”oxidative stress panel,” but they’re good. They’re not perfect, but the short answer is a good practitioner is going to be had. They have you on a good program for a good solid three months, that’s going to indirectly address all these those things anyway. So, it should be a non-issue.

Ari Whitten: Gotcha. Okay, so is there any other strategy that you feel you might commonly take with people dealing with adrenal fatigue types and things like. So we went over, some of the botanicals. We went over potential toxins, addressing some of those, and oxidative stress mainly via a diet.

By the way, actually, on that note real quick would you recommend saunas?

Dr. Bryan Walsh: Yeah, I’ve no problem with that. Yeah, I love saunas, I absolutely love, I just supercharged our sauna about a week ago. I have a far infrared sauna, and I added these near infrared heat lamps on the door, it’s oh my god it’s freakin.

Ari Whitten: So the light comes in through the glass door?

Dr. Bryan Walsh: Well it’s attached to the glass door. So as the glass door closes, so you have these for heat bulbs right in front of you, and the far. My wife hates it, it’s insane.

Ari Whitten: Inside of the sauna.

Dr. Bryan Walsh: On the inside the sauna, yeah.

Ari Whitten:  Oh, nice.

Dr. Bryan Walsh: Dude it’s like it’s the best experience. I love it”

Ari Whitten: I want to do that, I just can’t figure out how to get a wire in there without like damaging the wood on the sauna.

Dr. Bryan Walsh: You know, it went right underneath the where the door closes. It’s just, I got a lamp cord, I put it all together myself, but I just got a lamp cord and the door it goes underneath and the door closes over it, no problem. I mean, I don’t know how your door setup is. But ok I’ll  have to off target now. I can’t even I can’t even tell, it’s like night and day. Oh my God, it’s fantastic.

Anyways, yeah, I don’t have you know here’s the beauty about exercise, and about sauna is. Under the care of a practitioner, they can kind of walk you through. Your body will tell when you’ve had enough, then so you know. People can say globally, oh well people with low cortisol they shouldn’t sauna. You can’t say that. They might be able to do 130 degrees for 5 minutes. But it’s something, and it’s like with exercise you don’t have somebody go and do CrossFit. You might have them, if they do nothing, maybe to start to walk for five minutes, or a treadmill, or do a few bodyweight squats, or something. And then work their way up so to say globally that, people with adrenal fatigue can’t do a certain exercise, it shouldn’t a sauna, is not true at all. And in fact, they can. And I would suggest, it’s good but they just need to do it judiciously and as their body sort of dictates.

Ari Whitten: Yeah, I completely agree. And on a side note I think, actually, the avoidance of hormetic stressors like heat exposure, like exercise, is actually crippling to people over time, if they continuously avoid those things.

Dr. Bryan Walsh: Totally agree.

How finding your purpose can help you stay healthy

Ari Whitten: Yeah, so I was I was trying to ask – and then I kind of sidetracked myself – but is there any other strategy or two that you think, might be worth mentioning here as like common things that a lot of people benefit from?

Dr. Bryan Walsh: This is gonna sound out there, it has to do – I can’t even put it in a nice little package – it has to do with loving yourself, life, feeling connected, your purpose in life. I’ll say that.

Ari Whitten: It’s not that out there, I actually have a section, in that it’s under…

Dr. Bryan Walsh: Well, I mean, compared to what we’re talking about the physiology biochemistry of adrenal issues.

Ari Whitten: Yeah, I’m the same way, where I’m like such a science guy and then I want to avoid some of the woo-woo.

Dr. Bryan Walsh: No, it’s not woo-woo, know there’s that there’s science on this now. I mean, just to quickly state, you know there’s some really interesting research about the means with which we pursue happiness. And to pursue and there’s a lot of ways,  but the studies talked about two different types that there are eudaimonic and hedonic types of forms, of looking for happiness.

Hedonic as the name would suggest, is deriving a sense of happiness or fulfillment through your own means, for yourself. So you buy a new pair of shoes, you buy an electric guitar off eBay, you’re like man, I rock, I’m awesome, I’m happy now.

Whereas eudaimonic is, you derive a sense of happiness and fulfillment by helping a greater cause, helping other people, so like helping somebody across the street, or belonging to a non-profit organization.

Which is interesting, because you could write a book – and writing a book isn’t either hedonic or eudaimonic, it’s the intention behind it – you could write a book to say ”look how great I am, I’ve helped this many patients, I am awesome.” That’s hedonic.

You could write a book to try to change the world, and it doesn’t matter if you’re the author, have your picture, or your name on it, at all. That’s eudaimonic.

And it turns out – I won’t get into all the details of it – but it turns out that our genes know which way we’re living our life. The people who tend to live a hedonic life will tend to have a higher baseline inflammation, and lower immune function, towards a viral infection, so less macrophage activity, less natural killer cell activity. People that live eudaimonic, life have a higher natural killer cell. And natural killer cells, by the way, are anti-cancer, antiviral.

So, higher natural killer cell, and lower baseline inflammation just because of how you derive happiness in your life. And so I say that’s not, woo-woo, man, because they’ve studied this stuff and it’s in the literature.

So, I would argue that that of everything, we’ve talked about is the biggest piece.

Ari Whitten: Oh, wow.

Dr. Bryan Walsh: Now, will be connected correct somebody’s low cortisol? I have no idea. Will not be connected lead to low cortisol? I have no idea. It’s not been studied, nor can I put that together empirically in my patients. It’s too difficult to do.

But what I will say, is that  I think that that’s a huge piece. Do we have a purpose in life, do we have meaning in our life, do we mean something to someone else, do we feel significant to ourselves or to others, are we loved, or even at the very least do feel or experience love for somebody else?

I don’t know how that relates to low cortisol, but my suspicion is that there’s something there.

Ari Whitten: Awesome, I love that you brought that up because I and that you said that it might be the biggest piece. I think that’s really, really cool.

Dr. Bryan Walsh: What we believe changes our physiology. There are studies on that too. that I mean, I told you, I don’t get my mind blown very much.

Just briefly, there was a study – you probably saw this – there was a woman, she blended up a vanilla shake and she poured this vanilla shake into two made up containers. One was called sensi shake, and the other one was called indulgence.

And so, the subjects were asked to really look at the ingredients, look at how many calories, at how many fats, how many carbohydrates, and then they judge the patients in two categories. One was subjective on satiety, like do you feel full or not, and it was like this is the mind blower it was the exact same shake.

She poured it into one and poured it into another one. Looked, one can, one was the other. They drank one, they’re like ”I still feel hungry.” They drink the same shake in a different, full fat, full indulgence, high-calorie drinking, and they’re like, ”I feel good”

Ari Whitten: Yeah.

Dr. Bryan Walsh: But then the kick, dude, the killer, though, is they measured ghrelin – a hormone. The hormone was different. It’s a hunter hormone, and it was different. They drank the same freakin shake, but yet a hormone responded differently based on what they believed they were drinking.

That blew my mind. Blew my mind, man. What are the implications of that with the food that we eat? Whether we think it’s healthy or not, or like oh, it just blew my mind.

So, anyways when I say it may be the most powerful influence. I, you know, if the way we, if we feel like we have a purpose in life, makes us more or less likely to get a viral infection. And viral infections can lower our cortisol, then yes, then this may be one of the most important features of it.

Ari Whitten: Well, I’ve kept you on a little bit more than an hour. I feel like I could talk to you for five more hours because this has been a blast. But, is there anything you want to leave people with? Is there any kind of one last summarizing thought maybe that you want to leave people with and then we will close?

Dr. Bryan Walsh: One is that I wish I had realized what time I was doing this because my room is now pitch-black. It’s it’s five-fifteen in Maryland and with the time change. like I wish I had complied to that.

No, you know, I. The only other thing is, that’s a good question, that nobody knows what they’re doing. None of us. That science doesn’t prove anything, it disproves what we previously believed. That any practitioner out there is just doing the best that they can, given the knowledge that they have – some have more knowledge, therefore, may do a better job than others – but that generally speaking, we’re all just doing the best we can. But none of us knows what we’re doing.

And to the last piece, I released right now, I truly believe that – I don’t know how to say it – but believing in something bigger than yourself, having a true purpose in life, and I mean a purpose. Why you’re here, I think is is one of the…

Oh, and I’ll say this, add the last piece to that is our pursuit of health. If you really think about it, is not to be healthy. You think about it, it’s what it would health brings. It brings happiness, it brings perhaps feeling sexy to somebody else, it brings having energy so that you can play with your kids, it brings the avoidance of the pain of like not being able to think faster straight or something.

So, when people are constantly chasing this thing called health or wellness. That I just, I want them to know that that’s not what it is that you’re after. You’re not after health or wellness. You’re after what those things bring.

And to really evaluate those things in your life. Because, the pursuit of beauty you never arrive, you never arrive at optimal health, you never arrive at health and wellness and if that’s your goal, you’ll be chasing your whole life.

Ari Whitten: So awesome. Well, this has been so much fun. Really, I want to bring you on again, and I want to keep doing this I feel like I want to do a series with you because this is amazing.

Dr. Bryan Walsh: Sure.

Ari Whitten: But I think we’ll leave it at that for now, and thank you so much for the call and I know everybody’s  gonna love this.

Dr. Bryan Walsh: Cool, thank you, it’s my pleasure.

Ari Whitten: Yeah, enjoy the rest of your night.

Dr. Bryan Walsh: Thanks.

How To Treat Adrenal Fatigue – It’s Not What You Think – Show Notes

What the old model of adrenal fatigue is (4:20)
Why Hans Selye’s definition of cortisol levels and adrenal function is ”profoundly wrong” (6:57)
Why adrenal fatigue has become a catch-all- diagnosis (11:16)
The new model of adrenal fatigue (12:42)
#1 Functional Adrenal Insufficiency (14:31)
Why adrenal fatigue might be mitochondrial dysfunction (15:18)
Low cortisol is real (19:40)
How toxin exposure might be the cause of adrenal fatigue (20:57)
#2 Adrenal Suppression or Adrenal Inhibition (28:07)
How infections might cause adrenal suppression (30:43)
How leaky gut is linked to adrenal fatigue (34:52)
Chronic and stealth infections (35:47)
How low cortisol levels can be linked with cancer (40:16)
How low cortisol can be linked to PTSD and depression (43:22)
What supplements you can use to balance your cortisol levels (46:10)
When to consider functional adrenal insufficiency vs. environmental exposures (56:43)
How to address oxidative stress (58:52)
How finding your purpose can help you stay healthy (1:03:26)

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Why Stress Causes Fatigue and How To Overcome Stress

Why Stress Causes Fatigue And How To overcome stress Cover Image │ Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comStress causes fatigue and it is an energy killer, so how to overcome stress? Fewer things will crash your energy faster than going through intense psychological or emotional stress for weeks or months on end. Yet, most people don’t really know the reasons why stress wrecks our energy, the physical effects of stress, or how to reduce stress naturally and get their energy back.

Before we dig into 6 powerful strategies on how to overcome stress I want to share 16 reasons why stress causes fatigue in the first place.

What You’ll Learn:

  • The 16 ways stress causes fatigue
  • How stress causes you to make poor food choices
  • How stress damages your mitochondria
  • How to overcome stress through meditation
  • How lowering your sensory load helps you overcome stress

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The Truth About Adrenal Fatigue

For the most part, when people speak about how stress causes fatigue, it’s the story of “adrenal fatigue.”

You have probably heard the adrenal fatigue story before. It goes something like this: The adrenal glands produce stress hormones to respond to periods of stress, but when the stress becomes chronic, the adrenal glands get tired and “fatigued” so they can’t keep up with the demands. Then when you have “adrenal fatigue,” you get all sorts of symptoms like fatigue, anxiety, brain fog, and trouble sleeping. That’s the common way of thinking about how stress causes fatigue. Basically, for most people, it’s all about the adrenals.

Contrary to popular belief, and as I am about to show you, your adrenal glands are only a small part of the overall story of how stress causes fatigue.

It turns out that there are over a dozen physiological pathways in the body that can be a bridge between stress and health problems, and most of them have nothing to with “fatigued” adrenal glands. It’s perfectly possible for stress to cause fatigue (and all sorts of other health problem) without anything being wrong with one’s adrenal glands or cortisol levels.

So if it is not “fatigued adrenals” that explains how stress causes fatigue, then what is?

Rather than being caused by poor adrenal gland function, the symptoms associated with “adrenal fatigue” — fatigue, depression, anxiety, sugar cravings, brain fog, sleep problems and the others — mostly have to do with the connection between the brain, gut, immune system, endocrine system, and your mitochondria (your cellular energy generators). Specifically, I’m about to show you 16 science-backed ways that stress causes fatigue that don’t have anything to do with fatigued adrenal glands.

(Warning: There’s a lot of science in this article. I’ve explained things simply and succinctly, but if you don’t care to know all the science and physiology and you just want the quick summary and the practical strategies of how to fix the problem, scroll down to the infographic and the strategies to de-stress towards the bottom of the article. I’ve also put a video here for visual and auditory learners, so feel free to watch or listen to the information like a podcast, rather than read if you prefer that).

There are 16 mechanisms that stress can damage your energy levels. Once you understand the real mechanisms behind how stress causes fatigue, you are equipped with the knowledge to actually fix the problems.

 

1. Stress Causes Fatigue By Depleting The Endocannabinoid System

Image of the endocannabinoid system │ Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comCannabinoid. Interesting word, right? Sounds sort of like cannabis (a.k.a. marijuana). Most people are unaware of it, but we have an internal system called the endocannabinoid system that manufactures its own supplies of cannabis-like molecules. And despite the fact that very few people have ever heard of this system of the body, it’s one of the biggest players when it comes to your mood and energy levels.

The endocannabinoid system is plays a huge role in regulating our response to stress and helping us to re-establish homeostasis (optimal health). It is involved with:

  • Energy level and alertness regulation
  • Regulating inflammation
  • Fighting stress, fear, pain, and anxiety
  • Starting and stopping our body’s stress response

Given those four functions, it’s easy to see that if your endocannabinoid system isn’t functioning well, you’re going to have major problems. You’re going to be overwhelmed with stress, anxiety, inflammation and your energy levels are going to suffer.

According to breakthrough new research titled Neurobiological Interactions Between Stress and the Endocannabinoid System, it’s becoming clear that we’ve been neglecting a critically important system of the brain when it comes to health, energy, and our ability to respond to stress. Here’s what the researchers concluded:  “Collectively, these data create a compelling argument that endocannabinoid signaling is an important regulatory system in the brain that largely functions to buffer against many of the effects of stress…”[2]

Many researchers are now uncovering the links of how this system connects with all sorts of diseases. University of Washington neurologist Ethan Russo has done research suggesting that “’clinical endocannabinoid deficiency’ underlies migraines, fibromyalgia, irritable bowel disease, and a cluster of other degenerative conditions, which may respond favorably to cannabinoid therapies.” [3]

When stress is frequent and prolonged, it depletes and unbalances the endocannabinoid system. And since the endocannabinoid system is largely in charge of shutting down the body’s stress response system, this depletion of the endocannabinoid system is likely the key breaking point in the system that makes stress and dysfunction in our body chronic. That’s what makes it so our body can’t get back into balance, and then all sorts of problems emerge, like:

  • We slowly lose the ability to properly ward off fear and anxiety.
  • Since this system is responsible for shutting down the stress response, when it’s depleted, we lose the ability to turn off our stress response systems.

The reason I’m mentioning the endocannabinoid system first on this list is that it acts like the gatekeeper — it’s only once the endocannabinoid system is depleted that all these other mechanisms of how stress causes fatigue can take hold. Having a depleted endocannabinoid system is thus one of the major (or perhaps the major) mechanism that causes stress to become chronic and prevents the body from getting out of “stress mode.”

 

2. Stress Causes Fatigue By Throwing Off Neurotransmitters in the Brain

Your brain cells communicate with one another via compounds known as neurotransmitters. You’ve probably heard of some of these before, like serotonin or dopamine.

People also know of “neurotransmitter imbalances” which are thought to cause depression and other psychological and mood issues.

Here is the interesting part that many people are unaware of: Neurotransmitter imbalances do not usually just appear for no reason. Those neurotransmitter imbalances — what many think are the “cause” of many psychological issues — are themselves caused by other factors.

For example, chronic stress is a major factor known to induce deficiencies and imbalances of multiple neurotransmitters.

  • Chronic stress reduces levels of serotonin and dopamine, which are important players in regulating our mood, tension, energy, and motivation. [4],[5],[6] Low levels of either of these neurotransmitters can contribute to depression, anxiety, binge eating, addiction, lethargy, apathy and anhedonia (inability to take pleasure in life).
  • It can also affect other neurotransmitters like acetylcholine. Specifically, it can increase the activity of the enzyme that breaks down acetylcholine, so you end up with less acetylcholine in the brain. [7] That is a problem because acetylcholine is a main neurotransmitter in involved with stimulating wakefulness, cognitive performance, and energy. To sum up: Less acetylcholine means less energy.
  • Chronic stress can also induce GABA resistance. [8] GABA is an inhibitory neurotransmitter, so by lowering the brain’s sensitivity to GABA, it essentially prevents the brain from efficiently going into relaxation and rejuvenation mode. To sum up: GABA resistance means that you’ll be more stimulated and have a tendency towards racing thoughts, more fears, more anxiety, more tension, and poorer sleep.

By disrupting the balance of neurotransmitters in the brain, chronic stress can wreak havoc on our energy levels and mood. So this is yet another way that stress causes fatigue.

 

3. Stress Causes Fatigue By Decreasing Thyroid Hormones

stress causes fatigue by decreasing thyroid hormones│ Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comWhen it comes to energy (and just about everything else in our bodies, like immunity, cognitive function, muscle function, detoxification, libido, etc.), thyroid hormones are a major key.

If you want to know what happens when you don’t have adequate levels of thyroid hormones, just look up the symptoms of hypothyroidism. You will see things like fatigue, depression, anxiety, hair loss, chronic pain, muscle weakness, fat gain, and many others.

In short, if your thyroid hormones are low, the ability of all your cells to produce energy — from your brain cells to your heart cells to muscle cells to the cells of your liver and everything else — takes a hit. And when the cells of all those systems of the body are not producing energy adequately, they function poorly. So you start to get those symptoms that I just mentioned.

Here is the key point: Chronic stress lowers thyroid function and levels of the thyroid hormones. [9] In other words, chronic stress can act in similar ways to hypothyroidism in causing symptoms like fatigue, depression, hair loss, fat gain, pain, and many others.

Infocraphic of what health issues low thyroid hormones cause │ Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Lower thyroid hormones is yet another way that stress can wreck your energy (and predispose you to fat gain and all sorts of other health problems in the process).

 

4. Stress Causes Fatigue Through HPA Axis Dysfunction

When the endocannabinoid system is depleted, that can lead to chronic activation of the stress-response system, the HPA Axis.

What is the HPA Axis?

The HPA axis includes 2 parts of the brain and one gland in the body:
Infographic of the HPA Axis │ Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

These three parts work together to regulate numerous aspects of our physiology—from our alertness and mood, to our digestion, to our stress response and immune function, to our appetite and metabolism, to our energy levels.

Here’s an overview of how the HPA-Axis functions:

Infographic of how the HPA Axis Functions. Stress causes fatigue and throws the HPA Axis off │ Why Stres Causes Fatigue And How To Fix It, www.theenergyblueprint.comNormally, when the stress response system gets activated, it also immediately triggers a feedback loop that’s designed to shut down further stress system activation. This helps to calm you back down so you do not overproduce stress hormones or stay in a stressed state for too long.

But when you are chronically stressed (and the endocannabinoid system is depleted), the HPA Axis is chronically activated, then the HPA Axis starts to dysfunction. It starts to become resistant to the negative feedback loops telling it to calm down, which basically causes the whole system—HPA—to start to work abnormally.  When the HPA Axis dysfunctions, all sorts of things can go wrong in the body. Chronic stress response activation and HPA Axis Dysfunction is now known to be associated with dozens of different medical conditions: [10],[11],[12],[13],[14]

  • Burnout
  • CFS and Fibromyalgia
  • Anxiety disorders
  • Depression
  • Irritable Bowel Syndrome (IBS)
  • Bipolar disorder
  • Insomnia
  • Post-Traumatic Stress Disorder (PTSD)
  • Borderline personality
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Alcoholism
  • Seasonal Affective Disorder (SAD)
  • Diabetes
  • Alzheimer’s

Infographic of what chronic stress response activation is a kown factor of │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Disruption of HPA axis function is another way stress causes fatigue.

 

5. Stress Causes Fatigue By Lowering Your Intelligence

One of the other ways of stress causes fatigue is because it can indirectly harm energy levels is that it can quite literally make you dumber. It can actually shut down the centers of the brain involved in higher thought processes. According to Amsten et al, “Prefrontal cortical areas, which serve as the brain’s executive command centers, normally hold our emotions in check by sending signals to tone down activity in primitive brain systems. Under even everyday stresses, the prefrontal cortex can shut down, allowing the amygdala, a locus for regulating emotional activity, to take over, inducing mental paralysis and panic.” [15]

The reason this happens is that the kind of stresses our nervous system evolved for are not the same type of stresses we deal with today. If we had to run from a bear or from a rival tribe, we want the fear circuits to activate and switch on primitive survival physiology to help us get out of that physical danger.

The problem is that when you’re undergoing chronic psychological stress in the modern world, turning off your higher thinking centers and switching on fear circuitry does more harm than good. It makes the situation worse by leading to poor decision-making in almost every area of our lives, from work to relationships to making good choices in the context of lifestyle habits to support good health. For example, whether to break off a toxic relationship or not, whether go to the gym or not, or whether to eat a nutritious meal or McDonald’s, or whether to meditate or mindlessly browse social media. It’s easy to see how each of those decisions can sabotage your health and energy over time.Inforgraphic of how stress causes fatigue and poor decisionmaking │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

To make matters worse, it’s actually shutting down our self-control and higher-thinking centers, which makes it hard for us to even become aware of our self-sabotage behaviors and get ourselves back on track. In short, stress makes you act like you’re a lot less intelligent than you really are. And because poor lifestyle decisions impact your energy, this is another way stress causes fatigue.

 

6. Stress Causes Fatigue By Making You Hungry and Crave Sugar

Sugar cravings can lead to making poor food choices, which is another way that stress causes fatigue and can kill your energy. [16] If you are going for soda, doughnuts, candy, energy drinks, or cookies, it is a recipe for terrible energy levels.

The main reason why refined sugar can wreck your energy is the neurotransmitter orexin, which is the single most important neurotransmitter when it comes to wakefulness and energy levels. Don’t get thrown off by these sciency terms like “neurotransmitter” and “orexin.” All you need to remember is this: High Orexin = High Energy. And Low Orexin = Low Energy.

Infographic of how orexin and energy relates │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Poor food choices will directly impact on orexin for several reasons:

  • Large glycemic (sugar) loads directly suppress orexin [17]
  • Low fiber content and low protein content of the meals. Processed food rich in sugar tends to be low in both fiber and protein, which further suppresses orexin [18]
  • Poor food choices (i.e. processed foods) tend to increase inflammation, and inflammation is the most potent suppressor of orexin [19]

Energy Drinks, especially, causes fatigue as they sap your energy levels. Check out how energy drinks causes fatigue HERE

So while those sugary foods may give you an initial jolt of energy, they are making your energy worse in the long haul.

 

7. Stress Causes Fatigue By Causing Chronic Inflammation

Chronic inflammation is now being linked as a causal factor in hundreds of diseases.

Despite that, the truth is that inflammation isn’t all bad. It’s actually an important natural biological response to many threatening agents such as microscopic invaders (bacteria, parasites, fungi, viruses, toxic compounds, and pollutants). It’s also part of our body’s response to wounds, infections and many disease processes. The main purpose it serves is to eliminate dead and damaged cells, which is a critical process to repair those tissues back to normal. So, inflammation is a very important and beneficial thing in our bodies. Indeed, we could not live without it.

But chronic inflammation is another story altogether. In normal healthy circumstances, the inflammation response happens rapidly and then goes away when no longer needed, after a few hours or a few days. But when it does not go away, that is when things get bad…

Mood problems, fatigue, fat gain, weird symptoms popping up.

With chronic inflammation, all sorts of things go wrong with our body. And chronic stress is a major cause of chronic inflammation.

If you know anything about the physiology of stress, it might seem counterintuitive that stress increases inflammation, because it is known that cortisol (our main stress hormone) is actually anti-inflammatory. But with chronic stress, the body loses the ability to regulate inflammation properly and the situation changes dramatically…

How stress causes fatigue by triggering inflammation │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

“Inflammation is partly regulated by the hormone cortisol and when cortisol is not allowed to serve this function (due to chronic stress), inflammation can get out of control,” according to Sheldon Cohen, a researcher in the field. [20]

Cohen argued that prolonged stress alters the effectiveness of cortisol to regulate the inflammatory response because it causes immune cells to stop hearing the signal from cortisol to shut down inflammation. Of course, if you can’t shut down inflammation properly, it becomes chronic.

Chronic inflammation is now being linked with almost every disease imaginable, from heart disease to various kinds of cancer to depression to Alzheimer’s and many others.

And it has a very clear and direct impact on our energy levels by shutting down orexin levels. (Remember, orexin is the most important neurotransmitter when it comes to energy levels).

To sum up: Chronic stress causes fatigue through chronic inflammation, as chronic inflammation is a recipe for fatigue.

To learn more about Joe Cohen’s work, check out the podcast I did with him on How to Biohack Fatigue HERE

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8. Chronic Stress Causes Fatigue By Suppressing Your Immune System

Stress causes fatigue by lowering your immune system │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comOne of the other ways that chronic stress can be damaging is through lowering immune function. [21]

While many people think that whenever they get sick, it is because they “caught” something from someone else — some new bug that is going around — that is actually not the case most of the time.

Our bodies are full of all sorts of potentially disease-causing germs all the time. In other words, the bugs are usually already inside of us!

When we are healthy and our immune system is functioning well, it keeps these bugs at bay.

But when our immunity is weakened, our bodies become susceptible to these invaders taking hold. (If you think back on it, you’ll probably realize that most of the times you have gotten sick are during times of stress, or sleep deprivation, or overexercising, or some combination of those). Thus, one of the big problems with chronic stress is that it chronically suppresses immune function.

This can lead to getting new infections as well as reactivation of old latent viruses in your system. When that happens regularly, the body is being chronically overtaxed and is suffering chronic oxidative damage in the cells.

Many types of viruses also specifically attack the mitochondria (the energy generators in our cells), thus causing a big hit to our cells’ ability to produce energy. (Infections are implicated as being a big player in chronic fatigue syndrome and fibromyalgia).

 

9. Stress Causes Fatigue By Disrupting Your Circadian Rhythm and Sleep

Stress Causes Fatigue By Disrupting Your Circadian Rhythm and Sleep │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comOne of the most potent ways that stress causes fatigue is by impacting our sleep and circadian rhythm (the 24-hour biological clock in our brain that regulates our sleep and our wakefulness cycle). We’ve all had the experience of being stressed out by something going on in our lives and how that affects our sleep. Think racing thoughts keeping you up all night. Not very fun.

It is known that stress can disturb circadian rhythm. In turn, disrupted circadian rhythm results in all sorts of other issues:

  • Depression
  • Anxiety
  • Lower resiliency in the face of stress
  • Increased rates of dozens of diseases
  • Daytime sleepiness and fatigue

Stress causes fatigue by directly impacting on sleep in many ways [22], [23]:

  • It prolongs sleep latency (the time it takes you to fall asleep), which leads to chronic sleep deprivation
  • It greatly decreases the amount of slow wave sleep (the type of sleep we need to properly regenerate at the cellular level)
  • It can impact the emotional states you experience during sleep and dreaming, and can cause nightmares. This can lead to a vicious cycle where what’s happening during sleep is actually stressing you out even more instead of being a time when you are recovering from stress.

Loss of sleep (or poor sleep) is often regarded as the “mother of all health issues.” So the effects of stress on sleep should be a big concern of yours. This is perhaps the most common way that stress causes fatigue.

10. Stress Causes Fatigue By Making You Depressed

One of the other big problems with chronic stress is that it can trigger depression. By disrupting your mood and making you depressed, it can sabotage your energy levels.

Mood and energy levels are very much intertwined. Think about it: How many times in your life can you remember feeling like you are bursting with energy but also feeling really sad? How many times can you remember feeling terribly depressed but feeling like your energy is amazing? Both of those scenarios are extraordinarily rare. (Theoretically, if a severely depressed person smoked crack, they might be both depressed and energetic. But for most of us, we never experience that.)

Usually, energy and mood work together in positive upward spirals or negative downward spirals. Better moods facilitate better energy, and better energy facilitates better moods. And vice versa.

So one of the big problems with chronic stress is that it wrecks your mood. And along with that, your energy. There are many ways that stress wrecks your mood:

  • CRH (corticotropin releasing hormone, a hormone released during stress) and dynorphin (a peptide in the brain released during stress) both are implicated in causing depressive episodes. [24],[25],[26]
  • Chronic HPA activation is also known to induce depression. [27]
  • Chronic stress can cause neurotransmitter resistance and imbalances in the brain (as we talked about previously), and those neurotransmitter effects are linked with depression. [28],[29]
  • Chronic stress also decreases BDNF (an important peptide in keeping your brain cells healthy) and impairs neurogenesis (formation of new brain cells) — both of which are important in staving off depression.
  • Chronic stress causes certain important energy-regulating areas of the brain to atrophy (something called dendritic retraction). [30]

All of these things are very bad news when it comes to your energy levels. As if the feeling of depression weren’t bad enough, you now have all sorts of other physiological mechanisms that are suppressing your energy.

 

11. Stress Causes Fatigue By Causing Chronic Physical Pain

One of the biggest problems with chronic stress are the effects on the brain. We just talked about some of those effects in the last point on depression, with how stress affects neurotransmitters, BDNF, and chronic HPA activation.

But here is the even bigger issue beyond these specific individual mechanisms: chronic stress causes fatigue by literally changing the structure and function of your spinal cord and brain in profound ways. Let me explain how this happens:

Infogrphic of how pain response triggers a healthy and a chronically stressed body │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Infographic on how pain and stress triggers each other │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Normally, pain signals from the body travel through nerves to the spinal cord and then up to the brain. The brain then processes this information and we get the sensation of pain.

But with chronic stress, the brain begins to process these pain sensations with greater and greater sensitivity. So less and less of an actual stimulus (sensation) is needed to induce pain. In severe chronic stress and pain that’s gone on for years, this can get so severe that a person will feel even a light caressing touch as a sharp pain. (This is often the case in fibromyalgia, for example).

This does not happen because the touch was actually harming their body, but because their nervous system and brain have now been rewired into being so oversensitive that every sensation is now felt as pain.

It also forms a vicious cycle, because pain itself will contribute to even more stress.

Chronic stress causes fatigue because it can lead to chronic pain, and chronic pain can contribute to stress becoming even more intense and chronic. [31],[32]

 

12. Stress Causes Fatigue By Lowering Many Beneficial Hormones

Stress Causes Fatigue By Lowering Youth Hormones │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Another reason why stress causes fatigue is that it lowers your levels of many important hormones.

To understand what is going on here, you first need to understand a hormone called pregnenolone. Pregnenolone is a precursor hormone that can be used to make both stress hormones and sex hormones.

Whether it makes more stress hormones or sex hormones is largely dependent on the signals it is getting from the environment.

Basically, the body is asking “is the primary objective to procreate or to run for your life?”

So there is a sort of trade-off here — the more you place a demand on your body to make stress hormones (by being chronically stressed), the less of the anti-aging, energy-enhancing hormones you make.

If the body is getting a lot of stress signal, the adrenals will “steal” the pregnenolone away from being used to make sex hormones like testosterone and progesterone (which generally have very positive effects on our bodies) in order to make stress hormones. [33] Hence why this state of physiology is often referred to as “pregnenolone steal syndrome.”

This is a particularly bad situation for women because the majority of their testosterone (yes, women have testosterone too, and it is very important to their health!) is produced in the adrenal glands. (In men, it happens in the testes). The adrenals are particularly affected by pregnenolone stealing due to stress. So it is often women’s sex hormones that get hit the hardest by stress.Stress Causes Fatigue By Lowering Sex Hormones │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

But even in men (although testosterone is produced in the testes), chronic stress is still known to lower testosterone levels. [34]

The basic idea is that pregnenolone, DHEA, testosterone, and progesterone are anti-stress hormones, as well as mood and energy enhancing hormones.

They all take a hit with chronic stress, so all those functions in your body take a hit too.

In other words, when those hormones take a hit, you are likely to be more inflamed, in a poorer mood, performing worse, with higher stress and anxiety levels, and lower energy.

 

13. Stress Causes Fatigue By Damaging Your Mitochondria

Chronic psychological stress can also cause uncontrolled oxidative damage in our cells.

You have probably heard of “free radicals” and “antioxidants” before — i.e. the notion that antioxidants are good because they prevent free radicals from damaging our cells.

It turns out that the common notion of antioxidants as “good” and free radicals as “bad” is horribly inaccurate (despite how common it is for people to believe this idea — both regular people and even health professionals). Preventing damage in your cells is just not as simple as taking a bunch of antioxidant supplements. That’s why the vast majority of research on antioxidant supplementation fails to show benefits. The reality is that we actually have an internal antioxidant defense system inside our cells, and as long as the free radicals do not overwhelm our body’s capacity to handle them, they are not harmful in any way. In fact, they are beneficial to health when at a level that our bodies can handle. Think of exercise — exercise actually produces free radicals, or oxidants, and yet is beneficial rather than harmful to our health!

Short-lived things that produce free radicals (like exercise) can be very beneficial, but too much chronic oxidative damage (from free radicals) in our cells is a very bad thing.

The key distinction is this:

This situation does not really occur as a result of a deficiency of antioxidants in our diet, but when a stressor becomes so big and chronic that our internal antioxidant defense system is overwhelmed. (example: running two marathons a day every day vs. doing just 30-60 minutes a day of moderate-intense exercise). Reasonably amounts of daily exercise is extremely beneficial to your health, but if you do extreme amounts, you overwhelm the body’s antioxidant defenses and actually cause harm. That’s why they have the saying “The dose makes the poison.” 

Basically, when you have a chronic imbalance between the amount of stress occurring vs. your body’s capacity to handle stress, you’re going to get oxidative damage.

The same is true with psychological stress — the big problem is not all psychological stress. In small doses happening occasionally and then going away, psychological stress can actually be a good thing! It can make you tougher, more courageous, mentally stronger, and can stimulate you to grow as a person in every way imaginable. In fact, without any occasional stress in our lives, it is likely we would never grow! We’d feel no sense of purpose or meaning in our lives, and no sense of triumph if we never have anything challenging to do.

The big problem — much like the example above of running two marathons a day — is that when psychological stress becomes chronic, it wreaks havoc on our bodies. It will overwhelm our body’s internal antioxidant defense system and will result in uncontrolled oxidative stress.

In a study done in women where they compared one group on a junk food diet who were not stressed to another group on the same diet but also under chronic stress, the women who were chronically stressed had double the level of oxidative stress compared to those who ate a junk food diet and were not stressed. [35]

This chronic uncontrolled oxidative stress can cause a number of problems that will result in low energy levels, but the two biggest are:

  • It damages the mitochondria (which directly lowers our cells’ capacity to produce energy). [36] [37]
  • It can cause inflammation, which can damage key parts of the brain (namely the hypothalamus) that produce key neurotransmitters that regulate energy levels, like orexin.

│Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

 

14. Stress Causes Fatigue By Inducing a Leaky Brain Barrier

Our brain comes built with a sort of filter that’s designed to make sure that substances which shouldn’t get into the brain stay out of the brain. The problem is that chronic stress can cause certain types of immune cells in the brain to release histamine and various inflammatory compounds. Over time, these chemicals can increase permeability in the brain barrier. [38]

This basically means that substances which would normally be prevented from getting into the brain are now getting in, which leads to inflammation in the brain.

In turn, inflammation in the brain can wreak havoc on all sorts of brain areas that impact on health and energy. It’s related to depression and other mood problems, numerous brain diseases, and of course, fatigue.
Stress causes fatigue by inducing a leaky brain barrier │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

 

15. Stress Causes Fatigue By Flushing Out Beneficial Minerals

Chronic stress and HPA activation will also impact on mineral retention by the kidneys. We end up getting rid of more potassium and magnesium and hanging on to more sodium. [39],[40] This is especially problematic because most of us are already eat diets deficient in potassium and magnesium.

We need potassium to:

  • Regulate electrical activity of nerves and cells throughout the body
  • Regulate activity of the heart
  • Build proteins
  • Break down and use carbohydrates
  • Build muscle
  • Control the acid-base balance

Magnesium is an essential mineral that is involved in over 300 metabolic processes in our bodies.

Magnesium is involved in:

  • Cellular energy production
  • DNA synthesis
  • Cell signaling
  • Regulating electrical activity in the brain, heart, and muscles.
  • Detoxification

So it is easy to see why depleting these vital minerals can lead to all sorts of problems, including fatigue.

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16. Stress Causes Fatigue By Inducing Leaky Gut

Another way that stress causes fatigue us is the way it affects our gut. There’s much talk of “leaky gut” these days and all sorts of complex theories around what may cause it. And to be clear, much of that is valid. [41],[42],[43]

But the science actually indicates that stress itself can directly cause increased gut permeability (“leaky gut”)! This causes a number of issues:

  • It increases the amount of bacterial toxin (endotoxin) leaking into the bloodstream. This is a major cause of chronic inflammation. This process has been implicated in fat gain, anxiety, depression, inflammation, stress, fatigue, autoimmune diseases, and numerous other diseases. [44] By the way, it’s worth noting that endotoxin and leaky gut can induce low cortisol levels — without ever needing to invoke any explanation around “fatigued” adrenal glands. Chronic exposure to toxins and inflammation will cause the body to intentionally lower cortisol levels. I.e. It’s not an accident or the result of “worn out” adrenals — the body is doing it on purpose. Low cortisol levels can then contribute to trouble sleeping, depression, fatigue, low blood sugar, brain fog, and many other problems.
  • It can cause food sensitivities and intolerances [45]
  • It can contribute to irritable bowel syndrome (IBS) [46]
  • It can decrease flow in the small intestine, which can lead to overgrowth of harmful bacterial species [47]
  • It can cause gut pain and increase your sensitivity to gut pain [48]
  • The inflammation caused by leaky gut directly shuts down the neurotransmitter orexin, which makes you tired and low energy.

Poor gut health is a recipe for poor energy levels. So this is yet another way that stress causes fatigue.

 

6 Powerful Strategies On How To Overcome Stress And Get Your Energy Back!

│Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

Since I have now told you all the ways that stress causes fatigue, let us talk about how to overcome stress so you can start addressing and fixing the problem.

 

1. How To Overcome Stress By Minimizing or Eliminating Stimulants (at least temporarily)

While it is not known by most people, caffeine use (and nicotine use) have been scientifically proven to have numerous benefits for both mental and physical performance, and even in health and disease prevention in many cases.

Chrnic Overuse of coffee is another way stress causes fatigue │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comHowever, chronic use of stimulants can be counterproductive. There are several reasons why. For one, it tends to stimulate the stress-response pathways of the body — so if you’re already stressed and have overactive stress response systems in your body, caffeine will stimulate those systems even more. Also, it can create too much release of stimulating neurotransmitters in the brain, which eventually leads to neurotransmitter resistance and imbalances of several neurotransmitter systems in the brain. (I go through the science on coffee and energy levels in this video).

To sum up, what I go over in that article, caffeine works by blocking one of the brain’s neurotransmitters called adenosine. Adenosine normally works to calm the brain and make you relaxed. So by blocking adenosine, caffeine creates a stimulating and energizing effect. The problem is that when you do this every day, the brain feels overstimulated and then actually creates negative neurotransmitter adaptations to try to calm itself back down. What that ultimately means for you is that it lowers your baseline levels of mood, performance, and energy.

How To Overcome Stress And Coffee Addiction

If you currently are a coffee addict, your goal is to slowly and progressively ween yourself off of it over the coming 4-8 weeks. Decaf is your friend! Then get yourself clean for at least 3-6 weeks. I have more details on how to do this in this article on coffee and fatigue. (Note: If you are a daily caffeine consumer now, be aware that it is a drug dependence, so you are going to experience drug withdrawal symptoms like fatigue and headaches for the first 7-10 days that you go off. You can minimize or eliminate those symptoms by weaning off instead of going cold turkey.)

Trust me when I tell you that it’s worth it — your energy, mood, and performance will all increase after you go through this process as it is step one on the way to overcome stress.

 

2. How To Overcome Stress By Lowering Your Sensory Load 

Most of us living in the modern world are now constantly bombarded by flickering lights, rapidly changing sights and sounds, social media, text, phone, email, TVs, phones, music, games, movies. And all of that is on top of the hectic lives we live. These things are all foreign to our biology and tax our brain on a level that it has never been taxed before in human history.

To cope, the brain is constantly trying to figure out how to overcome stress and find a way to calm itself down. It does this primarily through trying to increase the “inhibitory neurotransmitters,” serotonin and GABA. But when these systems are constantly taxed in this way, it’s a losing battle and you eventually wear out the system and start to create neurotransmitter imbalances.

So think about the following activities you may be doing:

  • Always being on the go doing things without taking breaks to recharge.
  • Listening to loud aggressive music while driving or exercising.
  • Getting involved in exciting, fast-moving or violent movies (or games) before going to bed
  • Staring at a computer monitor for most of your workday. (Most people don’t realize it, but computer monitors actually flicker — they do it so fast that we can’t detect it with our naked eye — and that flicker actually is another source eye strain and on the visual processing centers of the brain that drains your energy. This is why they have now invented flicker-free monitors. I highly recommend getting one if you spend a lot of time on a computer each day. Here is where you can purchase one on Amazon.com).
  • Staring at the TV for hours.
  • Listening to overly stimulating background music (or listening to music with lyrics while working).
  • Being indoors under artificial light (especially fluorescent lighting) for most of the day. (Note: Fluorescent lights also flicker, which causes eye strain and drains your energy).

 What to do to lower stimuli to the sensory organs.

  • Do not watch the news, fast-paced, or violent movies within 1 hour of bedtime.
  • Take small 5 minute breaks throughout your day doing something you enjoy.
  • Get outside for at least 30 minutes a day. If you can get into nature, even better.

 

3. How To Overcome Stress By Optimizing Your Circadian Rhythm and Sleep

In the previous chapter on how stress causes fatigue, I talked about how stress causes a lot of sleepless nights due to racing thoughts which, ultimately, leads to depression, anxiety, and a whole lot of diseases.

That is why I started looking for ways on how to overcome stress and optimize the circadian rhythm.

To do this, I recommend 3 basic things:

Blue light at night is another way stress causes fatigue │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.comWear blue blocker glasses at least one hour before bed, preferably 2-3. I recommend the SafetyBlue SleepSavior brand (You can learn more about them here).

Download f.lux or Twilight apps on your computer, tablet and phone. These free apps will automatically lower the blue light emission of your device after sunset. (Note: There is no such app for televisions, so if you want to watch TV, you’ll need the blue blocking glasses.)

Get incandescent bulbs or red or amber colored bulbs for a few lights in your house in the areas you spend time in at night after sunset, as well as your bedroom and bathroom. Then after sunset, ONLY use those light sources (rather than your standard fluorescent or LED lights you’d normally use)

│Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

4. How To Overcome Stress By Doing Re-Charge Rituals Daily!

Learning to operate your brain optimally (i.e. to not be in “stress mode” all the time) centers around building Re-Charge Rituals into your life.

What are Re-Charge Rituals? They are predetermined periods of the day where you engage in consciously cultivating the kinds of brain performance habits you want.

You can’t expect your brain to know how to overcome stress, be good at relaxation, happiness, being in a state of high energy, focus, laughter/play, and gratitude … if you aren’t consciously building those brain pathways.

Or worse, if you’re unconsciously building the opposite brain pathways, as most people are. If your daily practice is running around like a chicken with its head cut off, always running from one thing to the next, getting distracted with every email and text on your phone, using caffeine to get yourself going, feeling stressed and irritated, then guess what your brain will eventually learn to get good at? Yup, being in stress mode.

Building Re-Charge Rituals into your life is the way out of that mess. There are three critical types of Re-Charge Rituals you want to implement: 

  • Morning Ritual
  • Night-Time Ritual
  • Brief Rituals Interspersed Throughout The Day (ideally for 1-5 minutes every hour)

Why these 3 times? The bookends of the day program your brain how to behave!

How you start and end your day likely “program” the brain for what kinds of neural circuits to prune and which to reinforce. Are you starting and ending your day unconsciously with stressful, stimulating, ADD-promoting, anxiety-promoting behaviors? Or are you starting and ending your day by consciously putting in information and emotional experiences that program your brain for love, happiness, relaxation, focus, joy, and serenity?

If you want to have great energy levels, you better be doing the latter of those two options!

Here is a list of the most powerful strategies on how to overcome stress by using these in your Re-Charge Rituals:

Lifetyles strategies used to destress │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

 

  • Mindfulness
  • Positive Social Relationships
  • Breathe Deeply and Slowly
  • Laughter
  • Meditation
  • Prayer
  • Resistance Breathing and Breathing Exercises
  • Cold
  • Singing or Chanting
  • Dancing
  • Music and Sound Therapy
  • Yoga
  • Exercise
  • Massages
  • Sleep or Lay on Your Right Side
  • Tai Chi
  • Acupuncture
  • Spending time in nature
  • Naps
  • Power postures
  • Sunbathing
  • Hobby

Identify which specific techniques work for your personality and build a set of daily re-charge rituals into your life using those. Re-Charge Rituals are incredibly powerful when you use them daily. Trust me — you’ll thank me later.

 

5. How To Overcome Stress By Meditating

Technically, meditation falls into the category above on Re-Charge Rituals, but it’s so powerful and so important that I feel it deserves its own section.

The benefits of meditation are vast and are backed by a mountain of scientific evidence. Research has proven that meditation can:

  • Decrease stress [49]
  • Decrease anxiety [50]
  • Decrease feelings of loneliness [51]
  • Improves your ability to regulate your mood and emotions [52]
  • Decreases depression and makes you a happier person [53], [54], [55]
  • Decreases pain [56]
  • Decreases inflammation [57]
  • Increases your sense of connection to others [58], [59]
  • Improves cognitive performance [60], [61], [62]
  • Literally re-shapes your brain in powerful (and beneficial ways) [63], [64], [65]

In short, if you don’t meditate, you’re missing out on one of the most powerful forms of medicine that is available to humans. If there were a prescription drug that could do even half of what meditation has already been scientifically proven to do, that drug would be a trillion-dollar blockbuster that is prescribed to hundreds of millions of people. Here’s the cool part: The drug exists — it’s just that instead of popping a pill, you meditate.

I’ve been meditating using various practices off and on for over a decade, but as of recently, I have stumbled across the single best meditation method I’ve ever found in over a decade of searching. It’s called zivaONLINE, and I cannot recommend it more highly as a tool on how to overcome stress. I have taken the course myself and now practice twice a day. I consider meditation to be the single most powerful strategy for overcoming stress in existence, and zivaONLINE is the single best method I’ve ever found. (And don’t worry — there’s no culty stuff, and you’re not asked to follow any religious doctrine or dogma to do this). You can do the course here

If you want to know more learn more about how to overcome stress through meditation., listen to the podcast I have had the pleasure of making with Emily Fletcher, the founder of ZivaONLINE. Check it out HERE

 

6. How To Overcome Stress By Rebuilding and Balancing Your Endocannabinoid System

Remember, to get your body to be able to shut down “stress mode” and go into “safe mode” and “relaxation and regeneration mode,” your endocannabinoid system must be optimized. Without that, you’re going to stay stuck in stress mode no matter what you do.

So how do you actually rebuild and rebalance your endocannabinoid system?

Here are a few strategies to start rebuilding your endocannabinoid system:

  1. De-stress. Follow the previous recommendations to de-stress, as they are one of the key factors in how to overcome stress — in particular, building Re-Charge Rituals into your life. Ultimately, the endocannabinoid system becomes strained through physical and mental stress, so avoiding stress like the plague is critical to give your endocannabinoid system the opportunity to rebuild.
  2. Omega 3s. Omega-3 fats are vital to the health of your endocannabinoid system. Omega 3 fats help balance the endocannabinoid system by decreasing CB1 activity and increasing CB2 activity. Research has now linked the interaction of omega-3s with the endocannabinoid receptors in the brain with protecting the brain cells from damage and inflammation. [66] (If you’re supplementing, I strongly recommend krill oil over fish oil. And make sure to get a brand without cheap vegetable oil fillers. Krill oil also has the added benefit of astaxanthin, which is a powerful neuroprotective and anti-inflammatory compound. I recommend this powerful krill oil with high-dose astaxanthin from our store: Krill oil and astaxanthin combo.)
  3. Greens are a wonderful source of beta-caryophyllene, which is a phytocannabinoid that has powerful balancing effects on the endocannabinoid system by stimulating CB2 activity. Strive to double or triple the amount of dark green leafy veggies you eat each day. Try to eat greens in every meal.
  4. Cut Alcohol. Alcohol is a must-avoid compound when trying to rebuild your endocannabinoid system because it counteracts all the things we’re trying to do with balancing out our endocannabinoid activity.
  5. Massage, acupressure mats (or acupuncture) and self-myofascial release. This is another tool that studies have found promote a balanced endocannabinoid system.
  6. Use CBD. I’ve saved perhaps the most powerful strategy on how to overcome stress, for last. CBD, which stands for cannabidiol is a powerful endocannabinoid signaler found in marijuana and hemp plants. (To be clear, it is 100% legal in all 50 states, because it can also be extracted from hemp. It’s not psychoactive, like marijuana—the high comes from another compound called THC.) It is a powerful anti-anxiety and anti-stress cannabinoid signaling compound that supports endocannabinoid system balance. Hundreds of studies have now been done to show that CBD can benefit human physiology in numerous ways. (See here if you’re interested in seeing the research: https://www.projectcbd.org/conditions). To make a long story short, if you’ve been under chronic stress, CBD is simply one of the most beneficial compounds in existence. The one I recommend is from BluebirdBotanicals. I suggest using oral CBD, and here is the one I suggest getting. Also note that Bluebird Botanicals has been rated as the #1 CBD on the market, so that’s why I recommend getting your CBD from them.

The properties of CBD Oil is great for lowering stress │Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com

 

Recap

Stress is an energy killer. And while most people talk about the relationship between stress and energy by talking about “adrenal fatigue,” the reality is that stress does so much more damage to us than simply “fatiguing our adrenal glands” (as most people think). And most of the ways stress causes fatigue have nothing to do with our adrenal glands.

You now know 16 different mechanisms in the body that that explain how stress causes fatigue.

Hopefully, you now know how intertwined all of these factors are — stress, inflammation, mood, gut permeability, energy, pain, brain performance, sleep, immune function, the metabolism, mitochondrial health, and energy production. All of these exist in deeply intertwined cycles, where positive influences create positive input into all the other factors, and negative influences feed negative input into all the others.

Most people are stuck in creating negative downward spirals of more stress, inflammation, depression, anxiety, fatigue, sickness, poor sleep, and poor cellular energy production.

How to overcome stress, moving forward

What you want to do is use the 6 powerful strategies on how to overcome stress and get your energy back, in this article to break that cycle and create positive upward spirals of low stress, low inflammation, positive mood, great sleep, resistance to infection, and big healthy mitochondria that are pumping out lots of energy.

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Recommended Podcasts

Why Stress Causes Fatigue And How To overcome stress Cover Image │ Why Stress Causes Fatigue And How To Overcome Stress, www.theenergyblueprint.com
Meditation is great for eliminating stress. Listen to my podcast with Emily Fletcher and learn more about how to overcome stress through meditation.

 

Is Adrenal Fatigue Real? (Is Fatigue Caused By Poor Adrenal Function or Cortisol Issues?)

Is Adrenal Fatigue Real
“Adrenal Fatigue”… “Adrenal Burnout”… “Adrenal Exhaustion.” That’s the story we’ve all been told about what causes chronic fatigue. It’s that chronic stress wears out our adrenal glands and causes them to be unable to produce enough cortisol, and then we get fatigue and all sorts of other symptoms. But is Adrenal Fatigue real?

Since the term “adrenal fatigue” was coined in 1998, the theory of adrenal fatigue has gained enormous popularity and is now believed by millions of people all over the world.

Yet, at the same time, “adrenal fatigue” is actually not accepted as a legitimate medical condition by conventional medicine. So how can it be that a theory which is so popular among natural health practitioners and millions of people in the general public not even be accepted as a real medical condition by conventional MDs?

Is adrenal fatigue real? Given how controversial this condition is, we need to take a closer look at the science to find out whether the research supports the idea that adrenal fatigue/cortisol abnormalities really are the major player in chronic fatigue.

This article is the most comprehensive analysis of the scientific research from the last 20 years that has examined the link between cortisol levels and chronic fatigue.

My hope is that this information will start to shift the paradigm among the natural health community, and to help individuals like yourself find the best, evidence-based path to fixing your fatigue.

Download or listen on iTunes

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 What is Adrenal Fatigue? And What Are The Symptoms of Adrenal Fatigue?

For those that are unfamiliar with it, let’s do a quick overview of the theory of “adrenal fatigue.”

It is largely based on a researcher Hans Selye’s work from the 1930s-1950s, where he did testing on lab animals put under extreme stress. He found that they go through different phases of in their response when exposed to chronic stress, and then ultimately sort of shut down and are unable to maintain normal health – i.e. symptoms emerge. He proposed that these changes seemed to coincide with certain changes in hormones like adrenaline and cortisol along 3 specific phases, that ultimately ends in system-wide failure.

Adrenal fatigue proponents took Selye’s research and applied it to chronic stress in humans. Selye’s work was then used as support for the adrenal fatigue theory, and the idea that low cortisol (i.e. burned out adrenals) specifically is the fundamental cause of chronic fatigue and other symptoms that can emerge with chronic stress.

It generally is explained like this:

The adrenal glands produce stress hormones (like cortisol) to respond to periods of stress. Normally the system works just fine, but when the stress becomes chronic, the adrenal glands get worn out and “fatigued” so they can’t produce enough cortisol to keep up with the demands. Then you get fatigue and other symptoms.

The idea is that we go through a series of phases in response to chronic stress that looks like this:

The Theory Of Adrenal Fatigue│Is Adrenal Fatigue Real? (Why the Symptoms of Adrenal Fatigue are Not Actually Caused By Adrenal Problems), theenergyblueprint.com

  1. Alarm reaction– This stage is the body’s initial response to stress, which involves the adrenal glands producing lots of cortisol.
  2. Resistance– This stage happens as stress is prolonged and the adrenal glands are struggling to keep up with the demands on them to produce cortisol. Cortisol levels may be normal or high during this phase.
  3. Exhaustion– This is final stage and is typically characterized by low cortisol levels, which are a sign that the adrenal glands are “fatigued” and can’t produce enough cortisol to keep up with the demands on them.

The third stage of “exhaustion” became known as “burnout” and then as “adrenal fatigue.”

The idea was that when your adrenal glands are “fatigued,” you get all sorts of symptoms like:

  • Fatigue and lack of energy
  • Depression
  • Anxiety
  • Brain fog
  • Low blood sugar
  • Low libido
  • Waking up tired even after sleeping 7 or 8 hours
  • Cravings for sugary and salty foods
  • Trouble sleeping through the night (especially waking up between 2-4am)

Common symptoms of adrenal fatigue │ Is Adrenal Fatigue Real?

That is the basic theory of adrenal fatigue. It seems like a logical concept, and perhaps that is why it has become such a popular idea.

While this theory of adrenal fatigue has many people who believe in it and preach it, there are numerous problems with it.

As you’re about to see, based on research that has been conducted over the last 25 years, the evidence simply does not support the idea that adrenal function and cortisol levels are key players in chronic fatigue.

 

The Two Schools of Thought on the Question “Is Adrenal Fatigue Real?” – The Conventional Doctors and the Holistic/Functional Health Practitioners

The concept of adrenal fatigue is commonly taught among naturalistic and holistic health practitioners, and is commonly believed by virtually all health seekers in the general public.

There are literally thousands of articles online and dozens of books written about “adrenal fatigue.” So of course, it must be a real thing, right?

Yet, if you are under that impression, it might interest you to know that adrenal fatigue is actually not even accepted as a legitimate medical condition by conventional medicine.

In fact, the Endocrine Society, representing 14,000 endocrinologists (doctors who specialize in hormonal health), has publicly stated:

“’Adrenal fatigue’ is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms.” [1]

So there are basically two camps here:

  • Adrenal fatigue proponents (most of the natural health community). These are the people writing articles and books about adrenal fatigue, and claiming to treat it. When asked “is adrenal fatigue real?”, they’ll likely chuckle at the thought that anyone could not believe it’s real, because they believe they see it in their clinics all the time.
  • Conventional MDs. These people flat-out reject the notion that adrenal fatigue is legitimate medical condition. When asked “is adrenal fatigue real?”, they’ll most likely chuckle at the idea that anyone believes in it. They believe that the symptoms are not actually caused by poor adrenal function or cortisol issues, and that the science does not actually support the idea that the adrenals/cortisol is a significant cause of those symptoms.

Each group of people believes the other group is wrong and simply doesn’t understand what is really going on. Ask a conventional MD what they think of people who believe that adrenal fatigue is real and they’ll typically say that they’re quacks. Ask an adrenal fatigue proponent what they think of the conventional medical views on adrenal fatigue, and they’ll typically claim that it’s because the conventional medical world isn’t yet as scientifically advanced as they are, and hasn’t yet figured out that the adrenals and cortisol are behind the epidemic of chronic fatigue.  

So what’s the truth here – is adrenal fatigue real?

Is “adrenal burnout” or “adrenal fatigue” or cortisol issues the real cause of your chronic fatigue?

That’s what this article will answer, by using the most comprehensive analysis of the science on this topic that has ever been done.

Get ready to be shocked, because the science in this area tells an amazing story of what is really going on in chronic fatigue.

 

The Story Behind Why I Developed The Ultimate Scientific Guide to Evaluate The Question “Is Adrenal Fatigue Real?”

Within the natural health community, we’ve all been told a narrative of how our adrenal glands and cortisol control our energy levels and are the cause of our fatigue. I myself was brought up with this concept in my education in holistic health. I read many books about adrenal fatigue, was taught about it from my mentors, and even taught the concept to my clients for many years.

So when I saw how so many conventional MDs were brushing off “adrenal fatigue” as nonsense, I had an idea to use the scientific evidence to prove that adrenal fatigue is real.

I originally started with a simple idea to compile the research in support of adrenal fatigue. I set out to write a book giving an overview of the last 20 years of research into the link between cortisol and fatigue.

My goal was simple: To prove scientifically that “adrenal fatigue” is real, is a legitimate medical condition, and that adrenal fatigue is indeed the primary cause of fatigue. If someone wanted to know “is adrenal fatigue real?”, I wanted to create the ultimate science-backed resource for them to know that it is real and backed by research.

So I dug into the research and read every study I could find that relates to the link between cortisol levels (i.e. adrenal function) and fatigue. It was a process that took over 6 months of digging through the full texts of hundreds of studies.

And while my original intention was to prove the adrenal fatigue theory, something peculiar happened along the way…

I discovered that the evidence is wildly contradictory, and simply put, doesn’t actually support the notion that cortisol issues (or adrenal function) is a primary cause of chronic fatigue.

I discovered that my assumptions about what I would find were simply… wrong.

Now, in this scenario, what most people typically do is they ignore the evidence that conflicts with their views and then they pay attention to and cherry-pick only the evidence that supports their preconceived notions.

But instead of doing that, I decided to do something much more difficult: I decided to admit that my preconceived notions were incorrect, and to rethink the causes of fatigue. Then, I decided to do a comprehensive review of every study ever done on this subject and then I would let the science itself tell me what to believe.

  • If the science pointed to the notion that adrenal dysfunction/cortisol abnormalities are found in a large majority of people with chronic fatigue, I would have to conclude that cortisol issues are the primary cause (or at least major player) in fatigue.
  • And if the science showed that adrenal dysfunction/cortisol abnormalities are not found in a majority of people with chronic fatigue, then we have to admit that the science doesn’t support the idea that adrenal fatigue is the primary reason for chronic fatigue.

In this article, I will share with you literally all of the studies that have examined the link between cortisol and chronic fatigue so you can decide for yourself what the science shows about the question “is adrenal fatigue real?”

It’s over 20 years of studies. And here’s the most important part: You can verify for yourself that I have not cherry-picked the data – what you’ll find here is literally every relevant study done on this topic during the last 20 years. Please feel free to search for relevant studies that haven’t been included here, if you doubt that I’ve included all the research.

This is a scientific review unlike anything that has ever been done before. I have looked extensively in all books on adrenal fatigue and all prominent articles written online, and I have not found a review of the scientific literature related to the concept of “adrenal fatigue” that is even 1/10th as comprehensive as what you’re about to read. This is the most comprehensive analysis of the science on the relationship between fatigue and cortisol that has ever been done.

 

No Science on “Adrenal Fatigue,” So We Must Look at Research on the 3 Accepted Fatigue Syndromes

There is one big problem with trying to review the science on the question “is adrenal fatigue real?”

There isn’t any actual research on adrenal fatigue.

Let me explain what I mean…

Think of a medical condition. Diabetes, stroke, Alzheimer’s, obesity, hypothyroidism, celiac disease, lung cancer, depression, schizophrenia, psoriasis, dementia, or even obscure ones like Sjogren’s syndrome.

Now go to Pubmed.com (it’s a database of virtually all studies in existence – like Google for scientific studies) and do a search for that condition. (Or feel free to try it with any condition you can think up!)

You’ll notice that between hundreds to thousands of studies will quickly appear for each and every one of those conditions.

Now, guess how many you’ll find if you look up “adrenal fatigue”?

Virtually none. (Feel free to check for yourself).

In fact, it’s actually worse than a mere case of there being no scientific research. Why? Because if you do that search, you’ll actually find negative scientific data. That is, you’ll find research examining adrenal fatigue that has concluded that adrenal fatigue is a myth that has no basis in science.

The Negative Research on “Adrenal Fatigue,” Suggesting That It is a Myth (Click to read more) +
That systematic review of the scientific literature (all relevant studies on the topic) is even titled “Adrenal Fatigue Does Not Exist!”

I’m sure you can guess what the researchers found, but here’s their conclusion so you can read it for yourself:

“We found an almost systematic finding of conflicting results derived from most of the studies methods utilized, regardless of the validation and the quality of performed tests. Some limitations of the review include: (1) heterogeneity of the study design; (2) the descriptive nature of most studies; (3) the poor quality assessment of fatigue; (4) the use of an unsubstantiated methodology in terms of cortisol assessment (not endorsed by endocrinologists); (5) false premises leading to an incorrect sequence of research direction; and, (6) inappropriate/invalid conclusions regarding causality and association between different information.

  … This systematic review proves that there is no substantiation that "adrenal fatigue" is an actual medical condition. Therefore, adrenal fatigue is still a myth.”[2]

In short, there is no body of scientific evidence on “adrenal fatigue.”

So here’s the big problem: How can one review the scientific research on a condition that has virtually no scientific research?

Here was the key breakthrough: Since we cannot examine research on “adrenal fatigue” per se, we have to search elsewhere for studies that have examined the link between cortisol levels and chronic fatigue.

Fortunately for us, it turns out that there are actually 3 related fatigue conditions that are legitimate, recognized medical conditions that have thousands of studies on them:

  1. Burnout Syndrome
  2. Vital exhaustion (or Exhaustion Disorder)
  3. Chronic Fatigue Syndrome/fibromyalgia

It’s worth noting that the symptoms of these conditions have tremendous overlap with symptoms that are said to be associated with “adrenal fatigue.”

 

1. Burnout Syndrome

Symptoms Of Burnout Syndrome │Is Adrenal Fatigue Real? (Why the Symptoms of Adrenal Fatigue are Not Actually Caused By Adrenal Problems),theenergyblueprint.com

Here’s a description of the symptoms of Burnout Syndrome:

  1. Chronic fatigue
  2. Insomnia
  3. Forgetfulness/impaired concentration and attention
  4. Physical symptoms
  5. Increased illness
  6. Loss of appetite
  7. Anxiety
  8. Depression
  9. Anger

Note that these symptoms overlap with the supposed symptoms of “adrenal fatigue.”

 

2. Vital Exhaustion (or Exhaustion Disorder)

Here’s a description of symptoms of vital exhaustion:

Sumptoms Of Vital Exhaustion │ Is adrenal Fatigue Real?, THeenergyblueprint.com“Vital Exhaustion (VE) has three defining characteristics:

  1.  feelings of excessive fatigue and lack of energy,
  2.  increasing irritability, and
  3. feelings of demoralization.”[3]

 

3. Chronic Fatigue Syndrome/Fibromyalgia

First, it’s important to recognize that Chronic Fatigue Syndrome and Fibromyalgia are recognized medical conditions by conventional medical doctors and there is a large body of scientific evidence on the subject. (That’s in stark contrast to the virtually nonexistent research on “adrenal fatigue.”)

Here are the symptoms of Chronic Fatigue Syndrome:

Symptoms of Chronic Fatigue │Ia Adrenal Fatigue Real? Theenergyblueprint.com

The symptoms of “adrenal fatigue” and “chronic fatigue syndrome” are nearly identical.

Now, consider some peculiar coincidences:

Now, the author at www.adrenaladvice.com did a very interesting experiment. He got data from WebMD where they did a survey of people with CFS to see how many of them had a particular symptom. (E.g. 65% of people with CFS reported difficulty sleeping). Then he decided to conduct the same study with people who were either diagnosed with “adrenal fatigue” or suspected they might have it. What he found was remarkable, as you’re about to see in the charts below. The amount of people with adrenal fatigue and CFS reporting symptoms was almost identical! [4]

Primary CFS Symptoms │ Is adrenal fatigue Real, theenergyblueprint.com

Other CFS Symptoms │ Is adrenal fatigue Real, theenergyblueprint.com(Source for these data)

In other words, people diagnosed with adrenal fatigue (or those who self-diagnosed themselves with it) report the same symptoms as those with CFS! The percentages of each symptom are virtually the same!

Take a close look at the charts above. Do those really look like two different conditions? I think not.

More problems in differentiating CFS from “adrenal fatigue.” (Click to read more) +
Now, consider the fact there are no clear diagnostic tests specifically for either CFS or “adrenal fatigue.” Meaning, there isn’t any test in existence that one can get that would clearly get them diagnosed with CFS vs. Adrenal Fatigue. Diagnosis for both conditions tends to be done based on a process of elimination.  In other words, the diagnosis is not by a diagnostic test – it’s made by ruling out other possible conditions. I.e. if you have these symptoms (like fatigue) and they do various tests and they don’t find any other disease, then maybe you have CFS or “Adrenal Fatigue.”

Because there is no clear diagnostic test, these people are all in no man’s land. That is, their condition is open to interpretation – and the conventional MDs are likely to give out a diagnosis of CFS whereas the alternative practitioners are likely to say it’s “adrenal fatigue.” (And people are likely to self-diagnose themselves with either adrenal fatigue or CFS, depending on what information they previously came across on the causes of fatigue). The point here is that there is no objective scientific test that can diagnose someone with either adrenal fatigue or CFS, let alone to distinguish between the two.

What I am suggesting here is that a huge proportion of people who have these symptoms are simply using different words for essentially the same thing.

  • Alternative practitioners will say it’s “Adrenal Fatigue” and tell you the narrative of how chronic stress wears down your adrenals so they can’t produce enough cortisol.
  • Conventional MDs will say it’s “Chronic Fatigue Syndrome” (or perhaps burnout syndrome or vital exhaustion).

So here’s the interesting part…

While there is virtually no research in existence on “adrenal fatigue,” there is actually a mountain of evidence from 20 years of research examining the relationship between these fatigue syndromes and adrenal function/cortisol levels.

So even though there is no research on “adrenal fatigue,” we can assess the validity of the theory of adrenal fatigue by looking at the dozens of studies that have examined the link between cortisol and chronic fatigue/vital exhaustion/burnout syndrome.

Based on the logical assumption that chronic stress might underlie these fatigue syndromes, researchers have been conducting well-controlled studies for over two decades to try to find a link between cortisol levels and fatigue syndromes. There are literally dozens of studies on this that have been conducted by researchers all over the world for over 20 years.

And, as you’re about to discover, the results of those studies are wildly contradictory, and the studies have failed to show that abnormal cortisol levels are the primary cause of these conditions.

 

Is Adrenal Fatigue Real? The Answer from 20 Years of Research Examining The Cortisol-Fatigue Link

As a whole, the research looking at these 3 fatigue syndromes and their relationship with adrenal function/cortisol levels is all over the place and is massively contradictory.

  • Some studies are showing cortisol levels are higher in the morning…
  • or lower in the morning…
  • or higher all day long…
  • or lower in the morning and higher at night…
  • And the majority of studies show that there is no difference in cortisol between people who are burned out or chronically fatigued compared to those who are perfectly healthy.

To take this one step further, there are even studies which have examined the same people during burnout/chronic stress and after recovery from burnout/chronic stress that have shown:

  • Decreased cortisol levels as symptoms improve
  • Increased cortisol levels as symptoms improve
  • No change in cortisol levels as symptoms improve

In short, with dozens of studies done on this topic by scientists all over the world for over 20 years, there is no consistent finding of any particular cortisol pattern that is associated with chronic fatigue.

Indeed, the data show that for the vast majority of people with chronic fatigue, there is no difference in adrenal function or cortisol levels at all when compared with normal healthy people.

I’m about to show you the summary of all of the 79 studies that have been done on this topic over the last two decades, but first, let’s just keep in mind the basic predictions of the “adrenal fatigue” theory. If adrenal fatigue is a real thing, it would mean that when we look at the research, we can expect to find a few things:

 

Adrenal Fatigue Predictions

If poor adrenal function/low cortisol were the primary cause (or even a major cause) of chronic fatigue/burnout…

  • PREDICTION #1: We should find that all (or at least a large majority of) people with chronic fatigue/burnout have low cortisol levels (or at least some type of cortisol abnormality).
  • PREDICTION #2: We should find low cortisol levels (or some type of cortisol abnormality) at the onset or early stages of chronic fatigue conditions.
  • PREDICTION #3: We should see a reliable relationship where cortisol levels relate to symptoms. I.e. People with less severe symptoms have close to normal cortisol levels, and people with more severe symptoms have larger cortisol abnormalities.
  • PREDICTION #4: We should see a reliable relationship where, as symptoms improve, so do cortisol levels.
  • PREDICTION #5: We should find that raising cortisol levels should improve symptoms dramatically (as it does in true adrenal insufficiency/Addison’s disease).

 

Adrenal Fatigue Predictions, Is Adrenal Fatigue Real, theenergyblueprint.com

As you’re about to discover, the actual evidence does not support any of these five basic predictions of the adrenal fatigue theory.

Now I’d like to actually show you all of the studies and what they found, so that you can come to your own answer to the question “is adrenal fatigue real?”

Let me emphasize again that this is essentially the entire body of scientific research examining the relationship of chronic stress and adrenal function. I.e. This is all the studies, so I’m not cherry picking the research to prove some theory—I’m showing you all the studies, including the minority of the studies which do show abnormal cortisol levels. When you look at all the studies – the entire body of evidence – it becomes readily apparent how contradictory all of the findings are. And specifically, it becomes apparent that cortisol abnormalities are not found at all in the majority of people with chronic fatigue or burnout.

Without further ado, here is the entire body of scientific research examining whether cortisol is linked with fatigue:

 

Now let’s look at the 20 systematic literature reviews on the link between chronic fatigue and cortisol levels.

 

The Systematic Literature Reviews on the Cortisol-Chronic Fatigue Link

The Overall Body of Scientific Evidence – What do the 79 Studies Say About The Link Between Cortisol Levels and Fatigue?

 

59 individual studies and 20 literature reviews

  • 15 of 59 studies give evidence for LOWER morning cortisol levels in people with chronic fatigue/fibromyalgia or burnout syndrome
  • 11 of 59 studies give evidence for HIGHER morning cortisol levels in people with chronic fatigue/fibromyalgia or burnout syndrome
  • 33 of 59 studies show no significant differences in cortisol levels in people with chronic fatigue/fibromyalgia or burnout syndrome (and/or that cortisol does not change as symptoms improve).

 

Evidence from intervention studies

  • 10 studies overall
  • 3 of the 10 studies showed a connection between cortisol increases and improvement in symptoms.
  • 7 of the 10 studies showed no connection between fatigue and cortisol changes.

 

Evidence from 20 literature reviews

  • The majority of reviews conclude that there are inconsistent and contradictory findings — i.e. some studies show high cortisol is linked with chronic fatigue/burnout, and others show low cortisol, and most do not find any cortisol abnormalities at all.
  • The most common cortisol abnormality is in the direction of lower cortisol. But these changes are small and not found at all in a majority of studies.
  • There is no specific cortisol pattern or change in HPA axis function that is unique to chronic fatigue/burnout.
  • The majority of reviews conclude that people with chronic fatigue/burnout have no adrenal/HPA axis dysfunction and have normal cortisol levels.

 

A Deeper Look At Some of The Most Revealing Research on the Cortisol-Fatigue Link

Now let’s examine a few of the most impressive and revealing studies more in-depth.

Now let’s look at some systematic reviews (the highest level of scientific evidence) of the research on the link between HPA axis (hypothalamus-pituitary-adrenal axis, the whole network of brain regions that control adrenal cortisol output) function and chronic fatigue syndrome.

Speaking on the studies on burnout and cortisol levels, the researchers said:

“When taken together, among all the studies that investigated HPA-axis function and burnout, 3 support an INCREASE in HPA-axis functions in burnout, 5 support a DECREASE in HPA-axis functions, and 11 did not support a significant relationship.”[5]

They concluded:

“The pioneering studies that focused on the relationship between burnout and dysregulation of the HPA-axis have yielded inconsistent results. Data from subsequent studies with improved designs suggest there is no HPA-axis dysregulation in burnout…”[6]

HPA Axis dysfunction can be found in a small subset people with chronic fatigue syndrome. Even here though, the research is certainly not particularly compelling that HPA Dysfunction is the cause (or main mechanism) of why people get Chronic Fatigue Syndrome. In fact, the overall body of science makes the case that HPA Axis Dysfunction is likely a result – rather than a cause – of chronic fatigue.

A systematic literature review titled The HPA axis and the genesis of chronic fatigue syndrome” reviewed the studies examining HPA Axis Dysfunction in CFS and concluded:

Recent prospective studies of high-risk cohorts suggest that there are no HPA axis changes present during the early stages of the genesis of fatiguing illnesses.”[7]

Naturally, if HPA-Axis dysfunction were the cause of chronic fatigue, it should be present and detectable in the onset and early stages of the disease. In other words, if populations at high risk for getting chronic fatigue are analyzed, and the researchers can find no link between abnormal cortisol levels and a later risk of getting chronic fatigue syndrome, that is a good indication that cortisol levels/HPA function is not a significant causal factor. Moreover, if people who only recently developed chronic fatigue syndrome are analyzed and no cortisol/HPA abnormalities are found, that is also a good indication that cortisol/HPA function is not a significant player in the condition.

It’s not accurate to claim that something is the cause, when that thing isn’t even detectable at the onset or early stages of chronic fatigue.

The researchers also noted that HPA Axis Dysfunction is not present at all at the onset or during the early stages of CFS, and thus, the evidence doesn’t support the notion that HPA Axis Dysfunction is the cause. Moreover, they noted that just by correcting sleep patterns or through Cognitive Behavioral Therapy, the HPA Axis Dysfunction can be reversed – even as someone continues to experience the symptoms of CFS. Here’s what they wrote:

“In summary, evidence suggests that, although there is HPA axis disturbance present in subjects with operationally defined CFS, it is not present before the onset of CFS or during the early phases of illness, but develops once the illness has taken a more chronic course.”[7]

They concluded:

“A reversed direction of causation (i.e. that the illness leads to HPA axis change rather than the other way around) is supported by the findings that there is an apparent absence of HPA axis changes early in the genesis of chronic fatigue states, and that modifying cognitive behavioural components of the illness leads to a normalization of the HPA axis.”[8]

In short, there is no compelling case that adrenal dysfunction/HPA axis dyfunction/low cortisol levels are playing a significant causal role in chronic fatigue. It cannot be the primary cause of chronic fatigue, just by virtue of the simple facts that:

  • It’s not present in the majority of people with chronic fatigue/burnout
  • It’s not present during the onset or early stages of chronic fatigue/burnout

Naturally, if something is not even present at the onset or early stages of the actual condition it’s being claimed as a “cause” of, then one cannot reasonably claim it to be a “cause.” Moreover, if abnormal cortisol levels are claimed as the “cause” of a condition, and it is then discovered that a majority of people with that condition don’t actually have abnormal cortisol levels, then we know that abnormal cortisol levels are clearly not causing the condition.

 

Is Adrenal Fatigue Real? – Summary Of Research Findings:

In summary, we can conclude with the following succinct summaries of the relevant literature:

  1. The majority of people with chronic fatigue/burnout appear to have perfectly normal cortisol levels. This is the most important point to grasp, because cortisol level abnormalities cannot possibly be “the cause” of a condition when most people with that condition don’t have cortisol abnormalities at all. Based on the research, we can estimate the percentages as follows:

• Roughly 20-30% of the overall population of those with chronic fatigue syndrome have low morning cortisol
• Roughly 10-15% of people with chronic fatigue syndrome have high

morning cortisol
• Roughly 65% or more of people with chronic fatigue syndrome have perfectly normal cortisol levels.

Overall-the-research-indicates-that-the-majority-of-people-with-chronic-Fatigue

  1. The overall body of evidence is contradictory. Studies find low, high, and perfectly normal cortisol levels in people with chronic fatigue/burnout. More than 20 years of research – over 60 studies, and 20 reviews of the scientific literature – have failed to generate any consensus about whether or not cortisol/HPA abnormalities even exist in chronic fatigue/burnout.
  2. A subset of people with chronic fatigue syndrome have low cortisol levels and blunted HPA axis activity. Overall, the evidence suggests this is the most common cortisol abnormality in chronic fatigue syndrome, among the minority of patients who have any cortisol abnormalities. (Remember, the majority of people with chronic fatigue have perfectly normal adrenal function and cortisol levels, and still another subset of people have the exact opposite cortisol abnormality).
  3. Cortisol/HPA axis dysfunction – even when they do occur in some people – are not present at the onset or early stages of the condition, and thus are likely not “causal.” (But it is certainly feasible that when cortisol abnormalities do occur, in a minority of people with chronic fatigue, they may act as a perpetuating factor in the condition that makes recovery more difficult).
  4. There is no specific change or pattern of HPA axis function or cortisol levels in either chronic fatigue syndrome or burnout syndrome. There is no specific pattern of cortisol/HPA dysfunction that is unique to chronic fatigue — the HPA axis abnormalities seen in some patients with chronic fatigue/burnout are also found in many other different conditions that have completely different types of symptoms. Thus, if cortisol levels or HPA axis dysfunction is claimed as a “cause” of chronic fatigue, it should be pointed out that it is extraordinarily unlikely that the same cortisol abnormalities could cause two (or 10) different types of conditions that have different sets of symptoms.
  5. There is a lack of longitudinal evidence that links cortisol changes to either worsening or improvement of chronic fatigue. There is little to no evidence that shows any kind of link between cortisol abnormalities causing chronic fatigue/burnout, as well as a lack of evidence showing that normalizing cortisol levels leads to improvement in chronic fatigue/burnout. In other words, more severe symptoms don’t typically relate to greater abnormalities in cortisol levels. And recovering from chronic fatigue/burnout is not typically paralleled by any changed in cortisol. In short, cortisol levels don’t appear to meaningfully relate to symptoms, and thus are unlikely to be the “cause” of those symptoms.

 

Does The Research Support The Predictions of Adrenal Fatigue or Not?

Please recall the 5 predictions of the theory of “adrenal fatigue” that we went over previously. As we can now see, none of the basic predictions of the “adrenal fatigue” theory are supported by the body of evidence.

  • PREDICTION #1: We should find that all (or at least a large majority of) people with chronic fatigue/burnout have low cortisol levels (or at least some type of cortisol abnormality). (NOT SUPPORTED BY THE EVIDENCE)
  • PREDICTION #2: We should find low cortisol levels (or some type of cortisol abnormality) at the onset or early stages of chronic fatigue conditions. (NOT SUPPORTED BY THE EVIDENCE)
  • PREDICTION #3: We should see a reliable relationship where cortisol levels relate to symptoms. I.e. People with less severe symptoms have close to normal cortisol levels, and people with more severe symptoms have larger cortisol abnormalities.  (NOT SUPPORTED BY THE EVIDENCE)
  • PREDICTION #4: We should see a reliable relationship where, as symptoms improve, so do cortisol levels.  (NOT SUPPORTED BY THE EVIDENCE)
  • PREDICTION #5: We should find that raising cortisol levels should improve symptoms dramatically (as it does in true adrenal insufficiency/Addison’s disease). (NOT SUPPORTED BY THE EVIDENCE)

In summary, the evidence does not support the theory that cortisol levels (or adrenal/HPA axis function) are a significant causal factor in chronic fatigue/burnout, and much evidence contradicts that conclusion.

 

The 4 Big Problems With The Theory Of “Adrenal Fatigue”

Beyond the simple fact that the research doesn’t support the notion that cortisol abnormalities have a clear link with chronic fatigue/burnout, there are also a number of other areas where the theory of “adrenal fatigue” is contradicted by the scientific evidence.

Specifically, there are four more big problems with the theory of adrenal fatigue.

Below are several pop-out boxes that go into detail on several other concepts showing that chronic fatigue is likely not being caused by any sort of adrenal dysfunction or cortisol abnormality. (Note: Click on the links below to open up the explanations for each problem).

PROBLEM #1 - Raising People's Cortisol Levels with Medication Doesn’t Fix Their Symptoms (and Can Make Them Worse in the Long Run) (CLICK TO READ MORE) +
Here’s a simple way to test the theory of adrenal fatigue: If “fatigued” adrenals that aren’t producing enough cortisol is the fundamental cause of the symptoms, then increasing people’s cortisol levels should make them better.

For example, in true adrenal insufficiency/Addison’s disease (an accepted medical condition, in contrast to “adrenal fatigue) where people truly have low cortisol levels, we know that administering synthetic cortisol (e.g. hydrocortisone) actually does have amazing, life-transforming benefits. It is a life saver for people with low cortisol levels.

This is indeed a very simple way to test the theory. If low cortisol levels are truly the fundamental problem in chronic fatigue, then raising cortisol levels should fix the problem (just as it does in Addison’s disease). And many prominent proponents of “adrenal fatigue” actually do precisely that – they attempt to treat people with hydrocortisone or other forms of cortisone/cortisol to artificially raise cortisol levels.

This idea has actually been around for a long time. It was popularized by the book “Safe Uses of Cortisol” by Dr. William Jeffries.

Jeffries explained a concept the “adrenal insufficiency period,” which is essentially the same as “adrenal fatigue” – too little cortisol being produced by the adrenals. He talked about several different problems that were supposed to be associated with these low cortisol levels:

Several Different Problems supposed to be associated with these low cortisol levels │ Is adrenal fatigue real, theenergyblueprint.com

  • Fatigue
  • Pain
  • Gastrointestinal problems
  • Inflammation
  • Mood problems

According to Jeffries, the problem here was too little cortisol, and thus, the solution he proposed was to administer synthetic cortisol (e.g. hydrocortisone) to increase a person’s cortisol levels.

Indeed, many alternative health practitioners still do use this approach, based on this thinking that lowered cortisol levels are causing the symptoms.

But the research shows that it doesn’t work, and that it often makes things much worse in the long-term.

It often does lead to some initial short-term success for a subset of patients. Likely because of two things:

  1. Cortisol is a powerful anti-inflammatory, so suppressing inflammation by pumping extra cortisol into the body can cause some initial benefits. (Think of how heroin or opium may have some initial benefits, but is not actually moving you towards health in the long run).
  2. The placebo effect will cause some subset of people to feel better with any medication (or even no medication at all – a sugar pill).

But what the research has shown is that when people with chronic fatigue (even the small segment who do have low morning cortisol levels) take external cortisol, it does not have significant benefit (and may even cause harm in the long run).

While initial studies seemed to potentially show some limited benefit[47] [48] (at least in the short-term), subsequent research which was more well-designed and longer term showed that taking more cortisol does not have benefit and may even cause worse outcomes in some people. Here are the results of the 3 studies conducted on this subject:

Study 1 – 70 patients were randomized to receive either hydrocortisone or placebo treatment for 3 months.[49] They found a significant improvement in 66.7% of patients taking hydrocortisone, and 54.3% of patients on placebo. Benefits were greater in the hydrocortisone group, but there was a remarkable amount of people reporting improvement on placebo, which is suspect. There was small improvement in a rating of “global health” but no significant change in ratings of fatigue for people taking hydrocortisone for 3 months.

Study 2 – 32 patients were put either on hydrocortisone or placebo for 28 days. 34% of patients on hydrocortisone reported a significant decrease in fatigue, compared with 13% reporting decreased fatigue while on the placebo.[50] While some patients reported reductions in fatigue, the researchers concluded the majority of our sample gained little benefit from hydrocortisone…”

Study 3 – This was the most recent, the most well-designed, longest duration, and the most conclusive study.[51] It was a double-blind, placebo controlled, crossover-design 6-month study with 80 people with CFS. (Note: “Crossover” means that the same individuals spent 3 months on placebo and 3 months on the cortisone treatment). The study put people on 3 months of placebo treatment and 3 months of active treatment with hydrocortisone and fludrocortisone.

Remarkably, at the end of the 6 months, they found that raising cortisol levels did not improve symptoms – there was no differences between treatment and placebo in patient-reported fatigue or well-being.”[52]

Importantly, they also noted that there weren’t even benefits to raising cortisol in the subgroup of patients with the lowest cortisol levels. The researchers explained:

“Finally, chronic fatigue syndrome is thought to be a heterogeneous disorder, and treatment with low-dose steroids may only be effective for a certain subset of

patients (my note: i.e. those with lower cortisol levels). However, our treatment was not beneficial in patients with the lowest cortisol levels.” [53]

Another study confirmed this finding

The patients with the lowest cortisol levels and adrenal reserve were not the most symptomatic, nor were they more likely to respond to hydrocortisone treatment.”[54

So even for that small subset of people with chronic fatigue who genuinely do have low cortisol levels, supplementing with external cortisol to raise cortisol levels back to normal still typically doesn’t give benefit.

Here are some conclusions from the studies which tested hydrocortisone treatment in people with chronic fatigue syndrome:

  • “We found that low-dose hydrocortisone treatment has mild side effects and affords minimal therapeutic benefit for CFS, but significantly suppresses adrenal responsiveness.”[55] (Note: Your adrenal responsiveness is critical to coping with stressors, so it’s potentially very problematic to do things which prevent the body from adequately responding to stress).
  • “Taken together, hydrocortisone replacement therapy cannot be recommended for clinical use because of the limited benefit, because of the loss of efficacy upon discontinuation and because of the adrenal suppression when using higher doses.”[56]
  • “According to the stress crash theory, restoring HPA axis homeostasis…would revert the immune abnormalities observed in ME/CFS and thus improve the symptoms. However, the evidence supporting this stress crash or adrenal burnout hypothesis in ME/CFS is not strong. … treatment with hydrocortisone or fludrocortisone appears to have limited, mixed, or even adverse effects in ME/CFS.”[57]

Overall, the research does not support the idea that cortisol levels are the primary factor causing fatigue and other symptoms in people with chronic fatigue syndrome.

Correcting cortisol levels via medication does not improve fatigue for the vast majority of people. This is why it is not used as a treatment by virtually all evidence-based physicians.

Again, this suggests that:

  1. The body is intentionally lowering cortisol levels, and it’s not due to “adrenal burnout” preventing the adrenals from producing enough cortisol.
  2. Cortisol is not the primary cause of the symptoms in chronic fatigue.

Moreover, raising the body’s cortisol levels to a level higher than what the body is trying to maintain comes with a number of potential side effects:

Potential Side Effects Of Raising THe Body's Cortisol Levels │ Is Adrenal Fatigue Real, theenergyblueprint.com

  • Weight gain
  • Insulin resistance
  • Bone loss/osteoporosis
  • Poor immune function
  • Sleep problems/insomnia
  • Acne and other skin problems
  • Mood changes
  • Chronic pain
  • Numbness or tingling
  • Fainting
  • Loss of muscle mass
  • Abdominal pain
  • Headaches
  • Heart disease
  • Fatigue
  • Fluid retention
  • Diarrhea
  • Facial swelling
  • Facial hair growth in women
  • Fever and chills
  • Dizziness
  • Brain fog
  • Loss of adrenal responsiveness (which hinders the body from adequately responding to stress, and makes one less resilient).

Based on this research, what can we say about the question “is adrenal fatigue real?” Simply put:

  • The reason why administering cortisol-raising treatments is not standard practice in medicine for treating chronic fatigue/burnout is because the research doesn’t support it.
  • Correcting cortisol levels has little if any impact on the symptoms associated with chronic fatigue, even in the subset of chronically fatigued people with low cortisol levels. (And it can potentially cause problems).
  • If raising cortisol levels back up to higher levels does not fix the chronic fatigue (or at the very least, provide significant benefit over a placebo), then low cortisol levels are clearly not the fundamental cause of the symptoms in chronic fatigue.
PROBLEM #2 - If a Potential Biomarker is Not Reliably Associated with a Specific Condition, then it is Not a Valid Biomarker (CLICK TO READ MORE) +
As you’ve now seen, there is no particular cortisol abnormality that is reliably associated with fatigue. Indeed, the majority of studies show that the vast majority of people with fatigue have perfectly normal cortisol levels.

And yet, a large percentage of alternative health practitioners are attempting to diagnose a specific fatigue syndrome based on cortisol levels. (E.g. “Adrenal fatigue” and “adrenal burnout” and “adrenal exhaustion”).

This is pretty crazy if you think about it. There is no other condition in the world where people would insist on using a diagnostic marker that the research shows is so inaccurate and inconsistent.

When you’re looking for a diagnostic marker of a disease, you want to use some kind of marker that would show up on a test that would let you know if a person has a particular kind of illness. What you want to find is a reliable diagnostic marker that tells you whether or not someone has that condition.

This marker needs to be found in the large majority of people with that condition. And it needs to not be found in the majority of people without that condition.

Think about this scenario for a moment: Let’s say you wanted to have a test to see if people have insulin resistance/type II diabetes.

Now, let’s say you wanted to do this by looking at fasting blood sugar levels. (That is actually the primary thing physicians look at to assess insulin resistance). Of course, what you expect to find is that people with more insulin resistance have higher blood sugar levels.

Now let’s say you didn’t actually find that! Let’s you analyzed the blood sugar levels of thousands of people with type II diabetes and found that diabetics have:

  • High blood sugar 25% of the time
  • Low blood sugar 25% of the time
  • Normal blood sugar 50% of the time

If that were the case, could you still use fasting blood sugar to diagnose insulin resistance?

Of course not!

This is basically the absolute worst diagnostic marker imaginable. They would never use a marker like that – they would throw it out immediately.

Why? Because they would recognize that it’s obviously not a valid marker to know whether or not someone has that condition!

Yet, that’s exactly what is going on with “adrenal fatigue.” Many practitioners are trying to use a diagnostic marker (cortisol) which simply does not have a reliable relationship to fatigue.

There is no other condition in the world where people would claim to use a diagnostic marker for a condition that is claimed to be sometimes high in the condition, sometimes low, and sometimes normal. In such a scenario, it would immediately be recognized that the biomarker is an invalid way of diagnosing the condition.

PROBLEM #3 - In Chronically Fatigued Persons with Low Cortisol, the Hormonal Profile Indicates that the Body is Intentionally Lowering Cortisol Levels, Not that the Adrenal Glands are “Fatigued” and Can’t Produce Enough Cortisol (CLICK TO READ MORE) +
Based on the research into the hormonal profiles of people with chronic fatigue, even in those who do actually have low cortisol levels, the indications are that the body isn’t producing less cortisol because it can’t produce enough (i.e. because the adrenals are “fatigued” as a result of chronic stress), but because the body is instentionally lowering cortisol levels.

This is a critical point that often goes unnoticed.

To understand this, it requires a bit of understanding of how the HPA axis works.

In short…

The HPA AXIS │ Is Adrenal Fatigue Real, theenergyblueprint.com

  • Corticotropin Releasing Hormone (CRH) is produced by the hypothalamus
  • Adrenocorticotrophic Hormone (ACTH) is produced by the pituitary
  • Cortisol is released by the adrenal glands

The key point here is that the adrenals (i.e. cortisol levels) are being regulated by the hypothalamus and pituitary.

Once we understand this, it tells us something critically important about whether the low cortisol levels are caused by adrenals that are failing to make enough cortisol or if it’s because the brain is intentionally telling the adrenals to produce less cortisol.

See, in Addison’s Disease (true adrenal insufficiency), it is truly a case of the adrenals not being able to produce enough cortisol.

How do we know this?

ATCH In Addisions Disease │ Is Adrenal Fatigue Real, theenergyblueprint.com

Because in Addison’s Disease, we see extremely high levels of ACTH.

What does that mean?

It means that the brain is screaming as loud as it can at the adrenals trying to get them to pump out more cortisol. Normally, more ACTH would lead to higher cortisol levels. But in Addison’s, the adrenals cannot respond to the ACTH signal and cannot produce enough cortisol.

So we see a clear pattern of:

  • High ACTH (i.e. the brain trying to get the adrenals to produce more cortisol)
  • Low cortisol (i.e. the adrenals can’t produce enough cortisol)

In burnout and chronic fatigue syndrome, we do not see this pattern at all.

  • As explained in the research above, most studies indicate perfectly normal cortisol.
  • Even in the small subset of people with lowered cortisol levels, we see normal or close to normal ACTH.

In other words, we clearly do not see a pattern of the brain calling for more cortisol to be produced and the adrenals not being able to produce it.

In addition, we also know from research on people with chronic fatigue that even low doses of hydrocortisone (which raises cortisol levels) suppress the body’s own production of cortisol.[10] What that clearly indicates is that the body wants cortisol levels exactly where they are, and trying to raise cortisol will cause the body to fight back and lower its production of cortisol even more.

If the adrenals were “fatigued” and unable to produce enough cortisol, we would expect to see that:

  • ACTH levels should be high. (They’re not high).
  • Raising cortisol (via hydrocortisone) to normal levels should produce dramatic benefits, and should not suppress the body’s own production of cortisol. (But it doesn’t have either of these effects).

In other words, the body is clearly making precisely the amount of cortisol that it wants to have – no more, and no less.

So what this means is that in the subset of people with lowered cortisol levels, it appears that the body is intentionally lowering cortisol levels.

This may be for several possible reasons:

  1. The body may intentionally lower cortisol to allow the body’s immune and inflammatory system to function in the face of threats: If there are chronic infections and/or toxins being put into the body, cortisol can suppress the immune response too much. Thus in situations where there is a chronic infection present or chronic toxin exposure, the body may intentionally lower cortisol to allow the body’s immune and inflammatory response to function properly.[11] In a recent 2016 study, researchers sought to determine whether the underlying cause in chronic fatigue syndrome is cortisol/HPA dysfunction, or inflammation and oxidative stress. And they showed that the inflammation and oxidative stress causes the HPA axis dysfunction, rather than the other way around. Research has indeed shown that the HPA axis is downregulated in response to chronic inflammation.

The downregulation of the HPA axis in the face of a chronic inflammatory environment is well documented. The HPA axis becomes hyporesponsive following prolonged exposure to the cytokines, and this adaptation occurs relatively quickly.”

The researchers concluded:

The stress crash theory that HPA axis hypofunction drives the activation of immune-inflammatory pathways in ME/CFS cannot be validated. This theory is contradicted by a number of findings, including (a) HPA axis hypofunction is only present in a subgroup of patients, (b) there are no changes in HPA axis during the early stages of ME/CFS, and (c) the immunosuppressive effects of GCs are enhanced in ME/CFS. On the contrary, we propose that HPA axis hypofunction in ME/CFS may be explained by a number of mechanisms, namely (a) chronic inflammation, through increased levels of TNFα; (b) a Treg response with elevated levels of IL-10 and TGF-β that is evident in some ME/CFS patients; (c) increased activity of (oxidative and nitrosative (O&NS) pathways, especially increased nitric oxide (NO) production; and (d) the effects of infection-related mechanisms that can downregulate HPA axis activity, such as LPS tolerance and viral infections…

HPA axis hypoactivity in ME/CFS is most likely a consequence and not a cause of a wide variety of activated immune-inflammatory and O&NS pathways in that illness.”[12]

If one is going to point the finger at some underlying cause, chronic inflammation and oxidative stress are likely better places to look than adrenal/cortisol changes. And to go one step further, the factors causing the inflammatory/oxidative changes.

  1. The body may intentionally lower cortisol as a simple consequence of poor sleep and certain lifestyle factors: Research indicates that lowered morning cortisol is not causal in fatigue syndromes, but likely arises as a consequence of a person’s behaviors, physical traits, or the very symptoms of the disease – e.g. disrupted sleep, medications, sedentary lifestyle, or simply being overweight.[13],[14] (We will discuss this in more detail in the next section).
  2. The body may intentionally lower cortisol as a way to facilitate the body’s healing response: Some hormone specialists have suggested that lowering cortisol levels is part of the body’s healing response, and that downregulation of the entire HPA axis is part of what happens when the body simply slows everything down to allow healing to occur.[15] (It is hard to objectively validate this with research, but it meshes well with the science and the experience of many clinicians who treat fatigue).
  3. The body may intentionally lower cortisol as part of the body’s downregulation of all many physiological systems in chronic fatigue: Research indicates that chronic fatigue is associated with a systemic, whole-body lowering of metabolic rate and energy production.[16]Essentially, this research suggests that virtually all of the functions of the entire body slow down in chronic fatigue. So in this case, lowered cortisol levels are potentially just one of hundreds of lowered chemicals in the body that can occur in chronic fatigue. (Interestingly enough, the study which found this body-wide shutdown of the metabolism actually found normal cortisol levels in people with chronic fatigue, despite hundreds of other metabolic markers being downregulated. [17] So even here, we get more evidence that cortisol levels are not a major player in chronic fatigue.)

In short, the actual hormonal profile of fatigued persons who have low cortisol does not support the notion that their adrenals are “fatigued” and cannot produce enough cortisol.

Rather, it indicates that the body wants cortisol levels exactly where they are, and is not attempting to make any more cortisol.

PROBLEM #4 - The Same Exact Cortisol Pattern That is Claimed By Some to Be Associated with Chronic Fatigue/Burnout is Also Found in People who Are Simply Overweight, Night Owls, on, Antidepressants, or Simply Sleep Deprived (CLICK TO READ MORE) +
We have now seen that while most people with chronic fatigue/burnout have perfectly normal cortisol levels, there is a small subset of fatigued people with lowered morning cortisol levels.

The best estimate, from one review of the research is that 1/3rd of studies find lowered morning cortisol levels in roughly 1/3rd of people with CFS. (Note: If you do the math on that, it works out to be roughly 1/9th of overall people with chronic fatigue. But let’s be generous and estimate that it’s somewhere between 15-30% of people with chronic fatigue that have lower morning cortisol levels.)

To be more specific, the studies which have shown this cortisol abnormality have generally shown that it is specifically the morning cortisol awakening response that differs. (Even in these studies, most of them indicate that cortisol levels at all other times of day are perfectly normal, and that total cortisol output over 24 hours is also normal). And to get even more specific, the claim is that these people have a smaller peak in the rise in morning cortisol levels.

So one could perhaps reasonably believe from this that the lower morning peak in cortisol is a sign of “fatigued adrenal glands” that can’t produce enough cortisol, and that this is the real issue causing the symptoms of chronic fatigue/burnout (as some proponents of adrenal fatigue have).

Except there are several big problems with assuming that this cortisol pattern is a causal factor in chronic fatigue…

  • This same exact cortisol pattern is also found in numerous other groups of people without chronic fatigue/burnout.
  • The same exact cortisol pattern can be caused within days of engaging in simple behaviors (i.e. it is not caused by “adrenal exhaustion”).
  • And the same exact cortisol pattern can be caused by some of the very symptoms of chronic fatigue syndrome.

As one research review put it:

There is also no convincing evidence that any HPA axis changes are specific to CFS or a primary cause of the disorder rather than being related to the many possible consequences or corollaries of the illness.[18]

There are numerous factors that will, by themselves – i.e. without chronic fatigue – cause the exact same cortisol pattern of a low morning peak in cortisol:
1.     Excess body fat (i.e. being overweight)
Research has shown that the more overweight someone is, the lower their morning peak in cortisol will be.[19]

Here is the graph from the key study on this topic:

How Obesity Affects Cortisol Levels Graph │ Is Adrenal Fatigue Real?, theenergyblueprint.com

You can see clearly that being slightly overweight causes a slight lowering of morning cortisol, and being significantly overweight causes an even lower peak in morning cortisol levels.

Is the low morning cortisol a sign of chronic stress exhausting the adrenals, or simply being overweight?
2.     Night owl chronotype (i.e. staying up later)
You can see here from this graph how one key study showed that night owls (evening types) have the same exact low morning peak in cortisol.[20]

The CAR And Chronotype Graph │ Is Adrenal Fatigue Real. theenergyblueprint.com

Several other studies have also confirmed this finding.[21][22][23][24][25][26]

Here’s one study found nearly double the morning cortisol levels in people who were morning types compared to evening types.[27]

Dinural Salivatory Cortisol Pattern Graph │ Is Adrenal Fatigue Real, theenergyblueprint.com

So again, the simple trait of being a night owl is, by itself, enough to explain why a subset of people with chronic fatigue/burnout have this cortisol pattern.

Moreover, research has also shown that being a night owl is associated with many other illnesses, including burnout.[28][29][30] Research has also shown that people with CFS tend to have disrupted circadian rhythm, which will lead to this cortisol pattern.[31]

So it is likely that a sizable portion of people with burnout/chronic fatigue are night owls, and have this cortisol pattern simply because they are night owls.
3.     Night eating
Research has also shown that the simple habit of late night eating will cause a lower peak in morning cortisol levels.[32]
4.     Antidepressant use
Several different types of prescription and over-the-counter drugs can affect morning cortisol levels. One example is some types of antidepressants.

Here is a graph from one study that showed a lower peak in morning cortisol in people on antidepressants.[33]

This graph illustrates the morning cortisol awakening response in a group of people with stress-related exhaustion, that only differed based on whether they were on antidepressants or not.

The Impact of Antidepressant Use On Salivaary COrtisol │ Is adrenal Fatigue Real, theenergyblueprint.com

Again, both groups had stress related exhaustion, but only the group on antidepressants had the low morning cortisol awakening response.

So is the cortisol pattern the result of “adrenal fatigue” or simply taking antidepressants?
5.     Being sedentary
Several studies have shown that being sedentary can cause a lower morning peak in cortisol levels.[34]

Here is one study that looked at people with major depression to examine how their physical activity habits related to their cortisol patterns.

Estimated Salivatory Cortisol Curves By Different Levels │Is Adrenal Fatigue Real, theenergyblueprint.com

Higher physical activity led to a more pronounced rise (awakening response) and fall of daily cortisol levels.
6.     Having a day off work instead of working
Research has even shown that morning cortisol awakening response can be high one day and low the next, as a simple function of whether or not someone has work that day or it’s a weekend.

Specifically, having work (and thus a greater anticipated demand of the day) will lead to a higher cortisol peak, and having a day off work leads to a lower cortisol peak.[35]

Cortisol Awakening Response CAR at the workplace Graph │ Is Adrenal Fatigue Real?, theenergyblueprint.com

As you can see from the above graph, simply having a day off lowered morning cortisol awakening response in all groups.

Importantly, this change occurred from one day to the next, and thus contradicts the notion that it’s chronic stress that causes this lower morning cortisol pattern.

Side note: This also represents a significant confounding variable in cortisol testing, for two reasons:

  1. If people doing at-home tests take measurements on non-work days, they measure lower than on other days.
  2. Patients in chronic fatigue groups likely have more non-working persons compared to healthy people. So the studies comparing chronic fatigue patients to healthy people are confounded by the fact that many people with chronic fatigue will have cortisol patterns that reflect non work days.

So is it “adrenal fatigue” or simply a reflection of the perceived demands of the day?
7.     Poor sleep (or lack of sleep)
This is likely the biggest factor of all.

Several studies have shown that simply sleeping poorly will cause a lower peak in morning cortisol.[36] [37]

There is no need for chronic stress to exhaust the adrenals – a single night of poor sleep will cause the same exact cortisol abnormality that some people claim to be the “cause” of chronic fatigue.

Moreover, it is known that people who develop chronic fatigue syndrome often develop sleep problems. Thus, the sleep problems that emerge in many people with chronic fatigue may actually be the biggest factor in causing the low peak in morning cortisol in some people.

Here’s where this gets particularly interesting. There is research showing that people with chronic fatigue syndrome have unusually high rates of sleep disorders. For example:

People With Chronic Fatigue Have Sleep Disorders Infographic │ Is Adrenal Fatigeu Real? THeenergyblueprint.com

  • Studies have shown that close to 50% of people with chronic fatigue have some type of sleep disorder.[38]
  • One study found that more than 50% of chronic fatigue patients have either obstructive sleep apnea or sleep-related movement disorders (e.g. restless leg syndrome).[39]
  • Another study found that a whopping 46% of people with chronic fatigue syndrome have obstructive sleep apnea.[40]
  • Another large, population study showed that nearly 80% of people with chronic fatigue syndrome experience unrefreshing sleep and 20% had either narcolepsy or obstructive sleep apnea.[41]

When you consider how common poor sleep and full blown sleep disorders are in chronic fatigue syndrome – and when you consider that sleep problems alone will cause low morning cortisol levels – it’s actually a wonder that so most studies still show that most people with chronic fatigue have perfectly normal cortisol levels!

In short, the fact that poor sleep itself causes low morning cortisol, and the fact that poor sleep is so common in people with chronic fatigue strongly suggests the possibility that the lower cortisol isn’t causing the whole condition, but that low cortisol is simply an epiphenomenon – an effect of one of the symptoms of chronic fatigue: disrupted sleep.

Moreover, in case you would still be inclined to try to explain things through the lens of “adrenal fatigue” theory and say that the poor sleep is exhausting the adrenals, it’s worthwhile to note that the research has actually shown that even a single night of poor sleep will cause low morning cortisol, and that simply correcting the sleep can immediately resolve the cortisol pattern back to normal, within just days.[42] In other words, there is no need to invoke any theories about the adrenals getting “fatigued” in order to explain a low peak in morning cortisol – it may simply be an acute response to poor sleep. There is research that supports this:

“Both daily variations in sleep behaviors and ongoing sleep disturbance and fatigue are associated with a disrupted cortisol rhythm. In contrast, prior-day napping is associated with a more robust cortisol rhythm.”[43]

In other words, the morning peak in cortisol levels changes from one day to the next according to how much sleep you get. Sleep more and take a nap in the afternoon and you can bring your morning cortisol levels back up to normal the next day.

Another study in people with depression supports this view as well. They found that it is only those people who have trouble sleeping that have low morning cortisol – i.e. the people with depression who don’t have sleep problems have normal cortisol levels.[44] Again, this suggests that it is the sleep issues that are causing the cortisol abnormalities. (I.e. The low morning cortisol isn’t the “cause” of the depression – it’s simply an epiphenomenon that occurs in those depressed people who don’t sleep well.)

One study on people with burnout syndrome went so far as to say

The data supports the notion that sleep impairments are causative and maintaining factors for this condition.[45]

Another study in chronic fatigue syndrome concluded:

Neuroendocrine abnormalities (i.e. low morning cortisol) reported to be characteristic of chronic fatigue syndrome may be merely the consequence of disrupted sleep and social routine.”[46]

The simple fact is that this one factor – poor sleep – is, by itself, enough to explain why a subset of people with chronic fatigue have low morning cortisol levels.

To sum up:

It is known in the research that people who are night owls and/or poor sleepers have higher rates of burnout/chronic fatigue. So we know that if we compare a group of people with chronic fatigue/burnout to a group of normal healthy people, it is virtually guaranteed that the chronic fatigue/burnout group will have more night owls and/or poor sleepers (i.e. people with insomnia).

(And it is also extremely likely that the chronic fatigue/burnout groups will have higher rates of the other factors, like antidepressant use, lower physically activity, and excess body fat compared to the general healthy population).

Here’s the key point: Simply because the chronic fatigue/burnout group of people will likely have more individuals that have these factors going on – i.e. they are poor sleepers, night owls, sedentary, on antidepressants, or are overweight – these studies are very likely to conclude that overall, people with chronic fatigue/burnout have lower morning cortisol levels. (Since the people with these factors will skew the overall average cortisol numbers of the entire group).

Considering how common poor sleep is in people with chronic fatigue, it is actually shocking that most studies still find perfectly normal cortisol levels in the vast majority of people with chronic fatigue/burnout.

Indeed, the fact that so many common lifestyle factors (that are known to be especially common in people with chronic fatigue) can induce low morning cortisol levels, and yet, the majority of studies still find normal cortisol levels in most people with chronic fatigue adds further evidence to the notion that cortisol levels are simply not a significant causal factor in chronic fatigue.

The point here is to simply say that the proposed cortisol abnormality claimed to be associated with fatigue/burnout (lower morning peak in cortisol) it not actually not unique to fatigue/burnout – it arises all the time in people without fatigue/burnout. Nor is it evidence of “adrenal exhaustion” due to chronic stress – the same cortisol pattern arises in people all the time without any chronic stress over months or years taxing their adrenals.

Low morning cortisol levels do not mean that the adrenals have been exhausted and can’t produce enough cortisol – it is often an acute hormonal response to simply being a night owl, being overweight, being a night eater, being on antidepressants, or not sleeping well. It doesn’t even require months or years of these factors – it can arise from simply staying up late the night before, or poor sleep the night before. One can even have a lower morning cortisol peak from simply having a day off of work.

In short, low morning cortisol levels are not evidence of exhausted adrenal glands, but may simply be an acute hormonal response to being a night owl, medication use, night eating, being overweight, or poor sleep.

 

Making Sense of The Science: When Cortisol Levels Are Low (in a Minority of People with Chronic Fatigue), it’s Likely a Consequence, Rather than a Cause of Chronic Fatigue

We now know 4 important facts about the cortisol patterns seen in people with chronic fatigue/burnout:

  1. Low morning cortisol levels are not present in the majority of people with chronic fatigue/burnout.
  2. Low morning cortisol levels are not present at the onset or early stages of chronic fatigue/burnout.
  3. Raising cortisol levels (via medication) does not resolve the fatigue or provide any meaningful benefit over a placebo for the vast majority of people with chronic fatigue. (Including those with measurably low cortisol).
  4. Low morning cortisol levels can be caused by simply being a night owl, taking antidepressants, being sedentary, being overweight, or not sleeping well.

Taken together, these facts make it clear that that abnormal cortisol/HPA axis function is not a primary cause of chronic fatigue.

The cortisol abnormalities that do occur in a subset of people with chronic fatigue can also be easily explained. These abnormalities may simply be a consequence of some of these lifestyle and behavioral factors, rather than a cause of the whole condition of chronic fatigue/burnout.

Infographic │ Is adrenal fatigue real, theenergyblueprint.com

And this is why many researchers have concluded that HPA axis dysfunction and cortisol abnormalities are likely not a major cause of chronic fatigue/burnout, but arise as an effect of some of the lifestyle factors (e.g. insomnia, lack of physical activity, medication use, etc.) that commonly occur in chronic fatigue/burnout.

And this is precisely what one of the biggest reviews of the scientific research, The HPA axis and the genesis of chronic fatigue syndrome, concluded:

A reversed direction of causation (i.e. that the illness leads to HPA axis changes rather than the other way around) is supported by the findings that there is an apparent absence of HPA axis changes early in the genesis of chronic fatigue states, and that modifying cognitive behavioural components of the illness leads to a normalization of the HPA axis.”[58]

Another very recent systematic review of the science from 2013, titled A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome stated:

“the abnormalities (in HPA function) are subtle, and there is marked variation in basal and challenge tests in CFS patients and a real risk that these so-called abnormalities are simply confounds or epiphenomena.”

Another study concluded:

“Few studies report on severity of the fatigue or disability, and there is reason to suggest that some behavioural consequences of fatigue may themselves cause the shift in adrenocortical functioning … For example Leese et al. found that short-term night-shift working mimics the HPA changes observed in patients with CFS. They conclude that the changes observed in CFS may be secondary to disrupted sleep and social routine, and thus an epiphenomenon in terms of fatigue causation.”[59]

One of these systematic literature reviews concluded:

“Inactivity, sleep disturbance, psychiatric comorbidity, medication, and ongoing stress experienced by people with CFS will affect HPA axis function, and the findings that HPA axis dysregulation is more prominent in patients with a longer duration of illness suggest that the endocrine changes may be secondary.”[60]

One study on burnout went so far as to say:

The data supports the notion that sleep impairments are causative and maintaining factors for this condition.[61]

Another study concluded:

Neuroendocrine abnormalities (i.e. low morning cortisol) reported to be characteristic of chronic fatigue syndrome may be merely the consequence of disrupted sleep and social routine.”[62]

So are low morning cortisol levels in a subset of people with chronic fatigue evidence that adrenal fatigue is real? No.

While some people believe that a low morning cortisol peak means that a person has “adrenal fatigue,” it may actually just mean that a person has excess body fat, or is sedentary, or is taking medications, or is a poor sleeper, or stays up late (or a combination of those factors).

The simple facts presented above can easily explain why a subset of people with chronic fatigue/burnout have a smaller morning peak in cortisol levels.

Based on this research, what can we say about the question “is adrenal fatigue real?”

Since cortisol abnormalities are not typically present at the onset or early stages of chronic fatigue, and since cortisol abnormalities are not present at all in the vast majority of people with chronic fatigue, a reversed direction of causation – where cortisol abnormalities are caused by other factors, inactivity, medication use, poor sleep, etc. – is the most compelling explanation for cortisol abnormalities, in the minority of people with chronic fatigue who do have them.

 

More Problems With Adrenal Fatigue

There are also a number of other problems with the theory of “adrenal fatigue” and the way it is diagnosed and treated. In this section, we will address some of these issues that further question the scientific validity of the diagnosis and treatment of “adrenal fatigue.”

(In an effort to keep things organized and easy to understand, we’ve put the following sections in the pop-out boxes below. Please click the boxes below to unveil text for each of the below topics).

Inaccuracy of Cortisol Tests (Click to read more) +
Interestingly enough, most people who are diagnosed with low cortisol and “adrenal fatigue” or “adrenal exhaustion” don’t actually have low cortisol levels. There are several serious methodological problems in the way cortisol levels are often tested that lead to faulty results.

There are 4 reasons why this happens:

  1. Tests that don’t give the full picture of cortisol amounts.

See, there are different ways of measuring cortisol.

  • Saliva
  • Blood (serum)
  • Hair
  • Urine

The practitioners who believe in adrenal fatigue have generally relied on saliva measurements (also called the Adrenal Stress Index). Saliva measurements of cortisol are indeed a valid method of assessing free cortisol. But, it’s important to understand what is actually being measured. Saliva measurements measure unbound or “free” cortisol – i.e. cortisol not bound to a protein carrier molecule. This is only about 3-5% of total cortisol in our body at any moment. The rest of the cortisol may be bound or in some step of the metabolic pathways involved in clearance of cortisol through the urine. So saliva cortisol doesn’t really give the whole picture about total cortisol produced by the adrenal glands.

The claim in “adrenal fatigue” is that the adrenals get worn out and can’t produce enough cortisol. Yet, saliva measurements do not allow us to assess the amount of cortisol produced by the adrenals – only the amount of cortisol that is free cortisol in the body at a given time.

The ideal marker of total cortisol production in the body is measuring cortisol metabolites (breakdown products) in the urine, because that reflects the other 95-97% of cortisol that our body produces.

Why does this distinction matter?

Simple: Because research has now found that many people who have low cortisol based on saliva tests (and who are told that their adrenals are exhausted and can’t produce enough cortisol) actually show normal or even high total cortisol production.

(Note: This pattern of low free cortisol but high total cortisol is actually extremely common -- particularly in overweight people, which the majority of people in the Western world now are. So this scenario of low cortisol in saliva testing, but high total cortisol production is actually extraordinarily commonplace – to the point where most people who are told they have low cortisol levels based on saliva tests don’t actually have low cortisol.)

Want to know just how common this is? Here’s functional medicine practitioner Chris Kresser explaining it in more detail:

“According to unpublished data from a lab called Precision Analytical that does cortisol testing, of 2,000 test subjects that they’ve looked at with low free cortisol, only 15% actually had low total cortisol. So, put [in] a different way, people with low free cortisol were actually more likely to have normal or high total cortisol than they were to have low total cortisol.”[64]

This is clearly a big problem. Why? Consider that many practitioners prescribe external cortisol (hydrocortisone) to people that they diagnose with low cortisol.

In this scenario, a person might even be told that their cortisol is low, and then put on glucocorticoid medication or other substances to try to raise cortisol, not realizing that cortisol is already too high. This obviously has the potential to make a person worse.

Again, it’s worth emphasizing this because it’s so shocking: It is actually more common for a person with low cortisol on saliva tests to have normal or high total cortisol production, than to actually have low cortisol.

  1. Tests administered only once.

This is a fairly straightforward one. Many practitioners only do a single saliva test. This is simply not accurate. Cortisol levels fluctuate dramatically over the course of 24 hours. They even fluctuate dramatically within the span of a single hour, in the first hour after awakening (called Cortisol Awakening Response). So these single measurement tests simply are not accurate measures of anything.

To get reliable and accurate measurement of cortisol, one should ideally do multiple saliva tests over the course of 24 hours. Or at least, multiple time points within the first hour after awakening to assess the cortisol awakening response.

  1. Some functional medicine labs have revised their “reference ranges” in a very narrow range.

The “reference range” is the range of cortisol values that a lab uses to interpret lab results and say what is considered normal, or abnormal.

What this means is that by having a narrow reference range, more people will fall outside of the normal and thus will be diagnosed with low cortisol.

Many labs have changed the reference ranges in recent years, and these revisions are generally not supported by endocrinologists or based on sound scientific evidence.

In other words, some independent labs and individual practitioners simply choose to arbitrarily decide what they believe should be the “normal cortisol” values, and then create a very narrow range for it (much more narrow than conventional endocrinologists) and thus, many more people are diagnosed with abnormally low cortisol levels.

  1. Tests are often not administered at the correct time in the morning

Another massive problem with cortisol testing is that because of the huge change in cortisol levels in the first hour after awakening, taking the measurement 30 minutes or 60 minutes later than one was supposed to take it can give a reading that is dramatically lower than the actual cortisol levels.

As soon as we wake up in the morning and light enters our eyes, it initially a steep and dramatic rise in cortisol levels within the first 15 to 30 minutes after awakening. This is called the “Cortisol Awakening Response.” (This steep peak in cortisol levels accounts for over 50% of our total cortisol production during each 24 hour day.) Importantly, after the initial hour after awakening, there is a massive and rapid decline in cortisol levels.

To show you what I mean, take a look at this image of the cortisol awakening response.

Do you notice how much cortisol values change in just 30 minutes or an hour?

So what would happen if the test is administered just one hour or two hours later than it’s supposed to be?

You’d obviously get a wildly inaccurate cortisol level.

It turns out that this is exactly what has happened on a massive scale. Many of the labs doing these cortisol tests didn’t instruct people to take their first saliva sample within the first 30 minutes of after awakening.

So what this amounts to is that tens of thousands of people who have had cortisol testing for “adrenal fatigue” took their first saliva samples an hour or two hours into the morning, which misses the entire cortisol awakening response and gives a completely inaccurate cortisol reading. Specifically, it will give a much lower cortisol level than is actually the real amount of cortisol your body makes in the morning.

I can’t emphasize enough how big of a blunder this is. Accurate cortisol readings depend on the saliva sample being taken in the first 30 minutes after awakening. If you take your morning sample an hour or two after waking up, it is virtually guaranteed to get someone falsely diagnosed with low cortisol.

Based on the above factors, what can we say about the question “is adrenal fatigue real?”

It is likely that a sizable portion of people being diagnosed with low cortisol levels and “adrenal fatigue” actually have perfectly normal adrenal function and cortisol levels.

The Real Symptoms of Low Cortisol Don’t Match Up With The Claimed Symptoms of “Adrenal Fatigue.” (Click to read more) +
One of the most glaring problems with the “adrenal fatigue” theory is that the claimed symptoms (of adrenal fatigue) do not actually match up with the actual symptoms that are accepted to be associated with low cortisol.

Here are the symptoms claimed to be caused by “adrenal fatigue”:

Symptms claimed to be caused by adrenal fatigue

  • Fatigue and lack of energy
  • Weight gain (especially “belly fat”)
  • Depression
  • Anxiety
  • Brain fog
  • Low blood sugar
  • Low libido
  • Waking up tired even after sleeping 7 or 8 hours
  • Cravings for sugary and salty foods
  • Trouble sleeping through the night (especially waking up between 2-4am)

And here are the symptoms that are actually caused by low cortisol levels:

Symptoms of low cortisol levels │ is adrenal fatigue real, theenergyblueprint.com

  • Fatigue
  • Weight loss
  • Low appetite or anorexia
  • Darkening of your skin (hyperpigmentation)
  • Low blood pressure, even fainting
  • Salt craving
  • Low blood sugar (hypoglycemia)
  • Nausea, diarrhea or vomiting
  • Abdominal pain
  • Muscle or joint pains
  • Irritability
  • Depression
  • Body hair loss or sexual dysfunction in women

You’ll notice that there are some of the symptoms on both lists – like fatigue, low blood sugar, depression, and cravings for salt.

But there are also several major discrepancies – it’s actually weight loss (not weight gain) that is associated with low cortisol, as well as things like nausea, diarrhea, vomiting, abdominal pain, muscle/joint pains, body hair loss, skin darkening, and loss of appetite (the opposite of sugary food cravings) that are all common symptoms of low cortisol that are not claimed to be associated with “adrenal fatigue.” 

In addition, it’s also worth pointing out that the symptoms claimed for “adrenal fatigue” are significantly more common occurrences in regular healthy people, and are not specific to low cortisol states or people with chronic fatigue issues, such as weight gain, cravings for sugary foods, anxiety, waking up tired, and trouble sleeping. These are all symptoms that apply to large portions of the general population, and are not unique to people with chronic fatigue or low cortisol. Thus, a huge percentage of the general healthy population will identify with these symptoms.

In fact, if you go to chiropractor and naturopath James Wilson, D.C.’s (the creator of “adrenal fatigue”) website, www.adrenalfatigue.org and take his symptoms-based quiz that supposedly helps determine if you have adrenal fatigue, here is his initial list of symptoms:

  1. Tired for no reason?
  2. Having trouble getting up in the morning?
  3. Need coffee, cola, salty or sweet snacks to keep going?
  4. Feeling run down and stressed?
  5. Crave salty or sweet snacks?
  6. Struggling to keep up with life’s daily demands?
  7. Can’t bounce back from stress or illness?
  8. Not having fun anymore?
  9. Decreased sex drive?

If you answered yes to even a few of these questions, he claims that this means you may have adrenal fatigue.

Now look over that list closely. Do you anyone who wouldn’t at least say yes to at least a few of those questions, at least some of the time?!

What I am suggesting is that he has coined a new syndrome (“adrenal fatigue”)…

then created a diagnostic criteria of adrenal fatigue where no matter whether a person has high, normal or low cortisol they may still be diagnosed with adrenal fatigue…

and then created a very broad list of general symptoms that even a large percentage of healthy people will identify with.

So I decided to do a survey to get to the bottom of this discrepancy between the actual symptoms of low cortisol levels vs. the claimed symptoms of adrenal fatigue.

I wanted to know if a population of people with fatigue – most of whom were convinced that they had “adrenal fatigue”(or have officially been diagnosed with it) – would actually identify with the real symptoms of low cortisol levels.

I took a sample of over 600 people with fatigue and then simply presented them with the actual symptoms that are associated with low cortisol (see the list above).

Then I simply told them

“Can I ask for your help with this little survey? It's a list of 12 symptoms, and I just want to know whether this list of symptoms feels like a good fit with YOUR symptoms, or if it doesn't seem like a very good fit.

In other words...

Do you read this list of symptoms and think "Wow, that sounds like what I have" or "No, that doesn't really sound like what I have."

Please only say "Yes, this sounds like what I have" if you identify with at least 6 of the 12 symptoms.
Otherwise, say "No, this doesn't really sound like it matches well with my symptoms"

Here is what I was covertly doing...

Again, the list of symptoms I posted are the actual symptoms of low cortisol levels. (Not the much different, much more vague and general, list of symptoms claimed for "adrenal fatigue.")

This simple survey was designed to find out if people with fatigue (many or most of whom believe they have adrenal fatigue) would actually identify with the real symptoms of low cortisol levels.

Here are the results:

  • 77 of 621 people (12.4%) of people said that the symptoms of low cortisol are very similar to their symptoms.
  • 544 of 621 people (87.6%) of people said that the symptoms of low cortisol are not similar to their symptoms.

Well, simply put, it means that the vast majority of people with fatigue do not have the symptoms associated with low cortisol levels. Over 8 out of 10 people with fatigue do not identify with the symptoms of low cortisol levels.

This is just one more piece of data to go along with dozens of actual scientific studies on this subject again suggesting that the vast majority of people with chronic fatigue do not actually have low cortisol levels.

Based on this research, what can we say about the question “is adrenal fatigue real?”

  • If most people with fatigue don’t have symptoms of low cortisol, it doesn’t make much sense to attempt to explain chronic fatigue by saying that it’s caused by low cortisol.
  • This is particularly true in light of the fact that we have already seen from the actual studies that most people with chronic fatigue do not actually have abnormal cortisol levels.
  • If studies don’t show low cortisol levels in the majority of people with chronic fatigue, and most people with chronic fatigue don’t identify with the symptoms of low cortisol levels, it simply does not make sense to keep focusing on cortisol as a valid way of explaining fatigue.
Many Different Cortisol Abnormalities (and Even No Abnormality At All) Can All Still Get You Diagnosed With “Adrenal Fatigue” (Click to read more) +
Another problem with the “adrenal fatigue” theory is the rules (or lack of rules) many people are using to interpret cortisol tests.

As you’ve now seen, cortisol levels are an extraordinarily bad predictor of whether or not someone is fatigued. A person who is completely exhausted and burned out from chronic stress may have high cortisol, or low cortisol or normal cortisol. As explained above, in the setting of any illness, this scenario should immediately get that biomarker ruled out as an invalid way of diagnosing a condition. Yet, many health practitioners still claim to diagnose “adrenal fatigue” based on cortisol measurements.

The interesting thing that many people have done though, is basically rigged the game to virtually always come out with an adrenal fatigue diagnosis.

The 3 Stages Of Adrenal Fatigue, is adrenal fatigue real, theenergyblueprint.com

  • If a person has high cortisol, they may be told they’re in the “first stage of adrenal fatigue.”
  • If they have normal cortisol levels, they may be told they’re in an early stage or middle stage, before their cortisol levels decline.
  • If they have low cortisol, they may be told they’re in a “late stage of adrenal fatigue.”

In other words, they’re using a diagnostic marker that can potentially always be used to claim that someone has “adrenal fatigue” – regardless of whether cortisol is high, low, or totally normal.

(It’s important to note here that these supposed “phases” of “adrenal fatigue” are not validated by scientific research. Indeed, as we’ve seen in the research, cortisol levels do not have any reliable relationship to the severity of chronic fatigue).

Again, in conventional medicine, in any scenario like this, this way of diagnosing people with a condition would immediately be recognized as scientifically invalid. A biomarker that is this inconsistently associated with a set of symptoms would immediately be thrown out as an invalid biomarker for that condition.

The Treatments Typically Given To People Diagnosed with Adrenal Fatigue Don’t Actually Raise Cortisol Levels (Click to read more) +
This is another area where the adrenal fatigue theory just doesn’t make sense. The claim with adrenal fatigue is that the adrenals get burned out and then low cortisol levels produce fatigue and many other symptoms.

Key point: The primary claim of adrenal fatigue is that it’s low cortisol levels in people with “adrenal fatigue.”

Here’s why that’s a critical point to pay attention to: The supplements typically prescribed by alternative health practitioners to correct adrenal health don’t have scientific evidence showing that they raise cortisol levels.

In fact, virtually all the evidence on virtually all of the supplements prescribed to people with “adrenal fatigue” have actually been shown in the research to lower cortisol levels!

Obviously if the claim is that someone has low cortisol levels, it doesn’t make sense to prescribe things which are known to lower cortisol levels.

Here are some of the most typical substances prescribed to people with “adrenal fatigue”:

The Most Typical Substances Prescribed to People with adrenal fatigue │ Is adrenal fatigue real? theenergyblueprint.com

  • Rhodiola rosea
  • Ashwagandha
  • Lemon balm
  • Licorice root
  • Phosphatidylserine
  • Ginseng
  • Tulsi

The lone exception that works to potentially raise cortisol levels (by inhibiting cortisol conversion to cortisone) is licorice root.

For all the other herbs and supplements commonly prescribed to people with low cortisol levels, the scientific evidence only shows that these substances lower cortisol levels!

I am not aware of any studies that have ever shown that any of these substances work to increase cortisol.

And in speaking with functional medicine and adrenal function expert, Dr. Bryan Walsh, he said “I have literally never seen adaptogenic herbs raise cortisol levels.”

If the claim is that people with “adrenal fatigue” have symptoms due to low cortisol levels, it does not make sense to prescribe substances that are proven to lower – not raise – cortisol levels.

Moreover, it also does not make sense to explain the benefits of these substances (which are real) through the lens of how they affect cortisol levels. (In reality, they affect many other systems of the body, including the brain, the immune system, inflammatory cytokines, and perhaps most importantly, the mitochondria (the energy generators in our cells)).

How does all of this relate to the question “is adrenal fatigue real?”

To sum up: If low cortisol is the problem, it doesn’t make sense to prescribe substances that are proven to lower cortisol levels.

Most Studies Attempting to Link Cortisol Levels with Various Illnesses and Symptoms (e.g. Chronic Fatigue/Burnout) Have Major Confounding Variables That Are Not Controlled For in The Research (Click to read more) +
As you saw in the previous section, it is now known that many physical traits and behaviors can induce cortisol abnormalities. Indeed, there are actually many more factors than just what I mentioned above that influence the daily cortisol pattern:

Factors that influence the daily cortisol pattern, theenergyblueprint.com

  • Body fat
  • Physical activity
  • Medication use (e.g. antidepressants, anti-anxiety meds, painkillers, opioids, stimulants, etc.)
  • Chronotype (night owls vs. morning types)
  • Eating habits (e.g. night eating)
  • Psychological traits (e.g. loneliness)
  • Genetics
  • Perceived overall stress load
  • Perception of upcoming stress of the day (e.g. workdays vs. non-workdays)
  • Psychiatric illness (e.g. depression, anxiety disorders, schizophrenia, PTSD)
  • Poor sleep

Importantly, the studies assessing cortisol levels in various illnesses have almost universally failed to control for most or all of these variables.

Thus the claims of how cortisol abnormalities are linked with various illnesses should be taken with a grain of salt.

These are all major confounding variables in the studies which have tried to link abnormal cortisol patterns to various diseases (including chronic fatigue/burnout).

What this means is that many of the supposed cortisol abnormalities in such diseases may simply be effects of symptoms of the disease (e.g. taking painkillers, poor sleep, or being physically inactive due to fatigue), rather than actual causes of the disease. Or they may simply be due to co-occurrences – for example, insomnia, depression, and excess body fat are all common co-occurrences in numerous different diseases.

In other words, while the common thinking of adrenal fatigue proponents is to point to cortisol abnormalities as a causal factor in the disease, there is much research indicating that it may be a reversed direction of causation – that these symptoms and lifestyle factors (e.g. poor sleep, excess body fat, medication use, etc.) are causing the abnormal cortisol patterns, rather than the other way around.

It’s also important to recognize that a lower morning peak in cortisol can be caused by numerous different lifestyle variables that change on a day to day basis, and are not valid evidence of “exhausted adrenal glands.”

Moreover, I have literally never heard any health practitioner even mention these confounding factors when they analyze cortisol results of individuals they are working with.

To give just one example of why this is problematic: Let’s take a person who has low morning cortisol levels and their doctor believes that it’s due to “exhausted adrenals.” In reality, it may simply be due to the fact that the person is a night owl and they typically go to bed very late and don’t sleep enough. Instead of addressing the person’s sleep hygiene habits, the doctor may prescribe hydrocortisone to treat the low cortisol levels. Of course, this mistake in treatment approach – treating the cortisol levels instead of treating the sleep habits – may have major health consequences over time.

As one 2017 review of the science on cortisol patterns in disease stated:

“Given that the bulk of the research examined was cross-sectional in nature, it is possible that a flattened DCS (diurnal cortisol slope, or pattern with a lower morning peak in cortisol) is a symptom, or a consequence, of a prior disease state. Many diseases result in physical pain and psychological stress. Consequently, a flattened DCS could be caused by pathophysiological or stress-related changes resulting from the experience of the disease itself. …Together, these findings suggest a reverse-causal explanation deserves more attention in future research.”[65]

Of course, it is still possible and likely that truly low cortisol levels may be a causal or perpetuating factor in some illnesses. The researchers of the 2017 literature review concluded that the effects likely go both ways:

“Given the transactional nature of the regulation of interrelated biological systems, and our findings of associations between flatter DCS (lower morning peak in cortisol and/or higher even cortisol levels) and multiple health outcomes, it seems plausible that reciprocal and cascading interactions among clock gene mechanisms, sleep, cortisol, inflammation, fatigue, appetite, behavior, and social and psychological experiences jointly contribute to the observed associations between flatter DCS and multiple types of negative health outcomes.”[66]

In short, while cortisol abnormalities may be a contributing factor in some conditions, the evidence being used to claim them as a causal factor is weak, and confounded by over a dozen variables.

In the case of chronic fatigue, we should be very cautious with assuming that a low morning cortisol peak is valid evidence of any sort of “adrenal fatigue.” As discussed above, low morning cortisol levels may simply be an indication of a sedentary lifestyle, excess body fat, poor sleep, night eating, disrupted circadian rhythm, taking certain prescription or over-the-counter drugs, or simply staying up late.

Moreover, we must remember that the research isn’t even consistent in showing any specific type of cortisol or HPA abnormality in relation to fatigue. As one review of the research put it:

“The above cited literature shows that the evidence on possible relationships between burnout and vital exhaustion on the one hand and HPA axis (dys)regulation on the other remain somewhat inconsistent. For example, there are studies showing either lower, higher or unchanged cortisol awakening profiles in groups with higher levels of burnout. … even some very well-conducted studies could not find associations between burnout and HPA axis dysregulations.[67]

Based on this research, what can we say about the question “is adrenal fatigue real?”

Virtually all of the research done trying to link cortisol levels with chronic fatigue (and most others diseases) is cross-sectional and thus, confounded by multiple factors that influence cortisol levels. So one should take such studies skeptically.

As discussed above, in chronic fatigue/burnout, the case for a reversed direction of causation – i.e. the illness and behavioral consequences of it, cause cortisol abnormalities in some subset of patients – is more compelling than the case for cortisol abnormalities being a significant causal factor.

 

Is Adrenal Fatigue Real – Summary

In summary, the scientific evidence does not support the notion that adrenal function/HPA axis function/cortisol are a significant causal factor in chronic fatigue.

Here is the bulletpoint summary of the key points in this article:

  1. The “adrenal fatigue” theory is not supported by the research.
  2. Studies have been conducted by researchers all over the world for over two decades examining whether adrenal/HPA axis dysfunction is a primary cause of chronic fatigue/burnout. 20 years of research into this has failed to show any type of HPA or cortisol abnormality that is reliably found in people with chronic fatigue/burnout.
  3. Overall, the research indicates that the majority of people with chronic fatigue/burnout have normal cortisol levels. Thus cortisol levels cannot reasonably be said to be the “cause” of chronic fatigue if it’s not even detectable in the majority of people with chronic fatigue.
  4. The research shows no clear link between cortisol levels and chronic fatigue/fibromyalgia/burnout. Some studies indicate increased cortisol in people with chronic fatigue/burnout, others show decreased cortisol, and the vast majority of studies show no differences in cortisol levels at all.
  5. Cortisol levels are not a valid biomarker of fatigue or burnout. If poor adrenal function/low cortisol were the primary cause (or even a major cause) of chronic fatigue/burnout, we would expect to find that all (or at least a large majority of) people with chronic fatigue/burnout have low cortisol levels. Yet, the vast majority of people with chronic fatigue or burnout from stress have no cortisol abnormalities at all. Thus cortisol levels are not a valid biomarker of chronic fatigue.
  6. Cortisol levels measurements are not a valid way of diagnosing people with chronic fatigue/fibromyalgia/burnout vs. normal healthy people. There is no specific cortisol/HPA abnormality seen in these conditions, and no abnormality at all in most people. A small subset of people (likely between 15%-25%) with chronic fatigue/burnout have a lower morning peak in cortisol levels. (This lower morning peak in cortisol occurs as a result of many common variables – including being overweight or simple lack of sleep – and is not unique to chronic fatigue/burnout). There is no evidence to suggest that this low peak in morning cortisol is a causal factor, since it is not present at all in the majority of people with chronic fatigue/burnout.
  7. Even studies that do find cortisol abnormalities show only very slight abnormalities — and typically still show normal overall 24-hour cortisol output. Thus, there appears to be little to no evidence suggesting that the adrenals are incapable of producing enough cortisol.
  8. Low salivary cortisol levels are not actually evidence of “adrenal fatigue.” Research that assessing total 24-hour cortisol output via urine shows that the majority of people who have low salivary cortisol levels actually have normal total 24-hour cortisol production by the adrenal glands.
  9. There are no cortisol abnormalities present at the onset or early stages of chronic fatigue. If poor adrenal function/low cortisol levels were a cause of chronic fatigue/burnout, we should expect to find low cortisol levels at the onset or early stages of these conditions. Yet, we do not find that. Thus poor adrenal function or low cortisol levels cannot reasonably be said to be a “cause” of chronic fatigue.
  10. Cortisol level measurements are not a valid way of assessing the severity of chronic fatigue. If cortisol levels were a major cause or contributor to chronic fatigue, we would expect to see a reliable relationship where the more severe the symptoms are, the larger the cortisol abnormality we would expect to find. Yet the research shows that cortisol levels are not a valid predictor of symptoms, and do not typically relate to symptom severity.
  11. Cortisol level measurements are not a valid way of assessing the cause of chronic fatigue. Cortisol level testing is useful for ruling out legitimate medical conditions like Addison’s disease and Cushing’s disease, but appears to be of little to no value in chronic fatigue/burnout.
  12. Cortisol level measurements are not a valid way of directing the course of treatment for chronic fatigue. Measuring cortisol levels to detect cortisol abnormalities is of little value in helping people with chronic fatigue, since treatments that target directly increasing cortisol levels have largely proven ineffective.
  13. Cortisol testing has many methodological flaws that can often lead to false diagnoses of low cortisol levels when a person doesn’t actually have low cortisol levels.
  14. The notion of “phases” of adrenal fatigue that have clear connections to specific levels of cortisol has not been validated by science. People with severe chronic fatigue may have high, low, or perfectly normal cortisol levels.
  15. The adaptogenic herbs often prescribed to people who have been told they have “adrenal fatigue” are only shown in the scientific research to lower cortisol levels – not raise them. It does not make sense to prescribe substances that lower cortisol, if the claim is that chronic fatigue is being caused by cortisol levels that are already too low.
  16. The symptoms claimed for “adrenal fatigue” are vague and generalized symptoms that are not actually unique to low cortisol levels or chronic fatigue. (I.e. A large portion of the healthy general population will say “yes” in response to many symptoms listed on “adrenal fatigue” questionnaires found online).
  17. Lower cortisol levels – when they do occur in a small subset of people with fatigue – are almost certainly not the result of the adrenal glands being “fatigued” and unable to produce enough cortisol. If this was the case, we would see a pattern of high ACTH and low cortisol levels (as is seen in Addison’s disease), which indicates that the brain is calling for more cortisol to be produced but the adrenals are unable to produce enough. This hormonal pattern is not seen in chronic fatigue/burnout. Thus, the body is likely intentionally lowering cortisol levels and is producing exactly the amount it wants to be producing. (Again, this may be to allow inflammatory and immune responses to function well).
  18. The vast majority of people with chronic fatigue (over 85%) do not actually identify with the real symptoms of low cortisol levels.
  19. In the most generous scenario of giving some sort of importance to cortisol levels in chronic fatigue, in the subset of people with lowered cortisol levels, it is possible that this hormonal abnormality may be perpetuating the condition by creating additional symptoms and/or making recovery more difficult. Even this has not been validated by research, however. Moreover, the fact that raising cortisol levels (via hydrocortisone) fails to reliably give benefits – even to those with lower cortisol levels – suggests that cortisol levels are of minimal importance in chronic fatigue.
  20. A lowered morning peak in cortisol levels is something that arises in numerous different conditions, and is not unique to chronic fatigue/burnout.
  21. A lowered morning peak in cortisol levels is not evidence of “adrenal fatigue,” since it can be found in healthy, non-chronically fatigued people who are simply sleep deprived, sedentary, on certain medications, or are night owls.
  22. Cortisol levels typically do not change in response to interventions that improve symptoms and/or normalize health. If cortisol levels were the major causal factor of the symptoms in chronic fatigue/burnout, we would expect to see a reliable relationship where, as symptoms improve, so do cortisol levels. Yet, the majority of intervention studies that have shown significant improvement in symptoms (e.g. energy levels) typically show that there are no changes in cortisol levels that parallel these symptom improvements.
  23. Fixing cortisol levels does not fix the fatigue. This is even true in people with lower morning cortisol levels. If low cortisol were the fundamental cause (or even a major cause) of chronic fatigue/burnout, then raising cortisol levels would improve symptoms dramatically. (As it does in true adrenal insufficiency/Addison’s disease). Yet, raising cortisol levels (via medication) does not significantly improve symptoms when compared with placebo treatment. (And it may be harmful in the long run).
  24. The focus on cortisol levels in chronic fatigue/burnout appears to be extremely misguided. Cortisol level testing appears to be of little to no use in chronic fatigue/burnout – either diagnosing chronic fatigue/burnout or helping to direct a beneficial course of treatment. The following five points make it clear that the focus on cortisol is simply not warranted by the research:
    • The vast majority of people with chronic fatigue or burnout from stress have no cortisol abnormalities at all.
    • Cortisol abnormalities are not present at the onset or early stages of chronic fatigue.
    • Based on the research, it appears likely that cortisol abnormalities (in the minority of people where they occur) may be just an epiphenomenon that results from being a night owl, taking antidepressants, inactivity, being overweight, or having sleep problems.
    • The majority of intervention studies that have shown significant improvement in fatigue typically show that there are no changes in cortisol levels that parallel these symptom improvements.
    • Interventions in people with chronic fatigue/burnout that directly target the cortisol abnormalities and raise cortisol levels (e.g. hydrocortisone) do not significantly improve symptoms vs. placebo.

Key Points in this article │ Is Adrenal Fatigue Real, theenergyblueprint.comSo is “adrenal fatigue” real?

Overall, the theory of “adrenal fatigue” is not supported by the scientific evidence.

Over two decades ago, the theories of the “stress crash” or “HPA crash” “adrenal insufficiency period” or “adrenal fatigue” came into prominence, and have become the dominant way of thinking about chronic fatigue among most holisitic/alternative/integrative health practitioners. These theories hypothesized that the likely underlying cause of many diseases such as chronic fatigue syndrome or burnout syndrome was hormonal abnormalities (e.g. low cortisol levels) resulting from chronic stress wearing out the adrenals or HPA axis, and that these abnormal cortisol levels would turn out to be the cause of the symptoms seen in these conditions. The most common variation of this idea is of course, the theory of “adrenal fatigue.”

The theory was logical and appeared to make sense on many levels.

Unfortunately, 20 years of research have failed to validate the theory. Moreover, many lines of evidence overtly contradict the notion that adrenal/HPA function or cortisol levels are a primary factor in chronic fatigue/burnout.

The research appears to validate the position held by the Hormone Foundation and Endocrine Society (that represents 14,000 Endocrinologist MDs):

“’Adrenal fatigue’ is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms.”

If we are going to truly find effective answers to chronic fatigue, we must let go of outdated concepts that aren’t supported by the evidence. I humbly suggest that if we want to make real progress in helping people with chronic fatigue, we must move beyond the “adrenal fatigue” theory and stop focusing on the adrenals/cortisol as thought it is the central cause in chronic fatigue.

Overall, the body of scientific research suggests that the focus on cortisol levels as the key factor in chronic fatigue is extremely misguided.

My hope is that this review of the research will help to shift the paradigm of how we approach treating chronic fatigue/burnout, and to help individuals struggling with chronic fatigue/burnout to find the best, evidence-based path to fixing their fatigue.

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Is Adrenal Fatigue Real? – Sources

[1] Newman T. 2016 Adrenal Fatigue: Does It Exist? What Is Adrenal Insufficiency?

[2] Cadegiani FA et al. (2016) Adrenal fatigue does not exist: a systematic review.

[3] Raikkonen K., et al. (1997) Vital Exhaustion – A Syndrome of Psychological Distress

[4] Adrenal Advice, Symptom Comparison: CFS vs AF

[5] SERTÖZ ÖÖ., et al. The Neurobiology of Burnout: The HypothalamusPituitary-Adrenal Gland Axis and Other Findings

[6] SERTÖZ ÖÖ., et al. The Neurobiology of Burnout: The HypothalamusPituitary-Adrenal Gland Axis and Other Findings

[7] Cleare AJ. (2003) The HPA axis and the genesis of chronic fatigue syndrome

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