The aim of this article by Dr. Andrew Neville is to give you an in-depth knowledge of fatigue and how to get your energy back.
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By way of more than 300,000 patient interactions, we at Clymer have learned a great deal about our patients with Adrenal Fatigue.
Patients with Adrenal Fatigue are a cut above the rest. They are go-getters with “Type A” personalities. They are usually more caring and conscientious than most. They possess above-average intelligence, and they are responsible enough to have educated themselves about their health challenges.
And if you’re like them, you will identify closely with this information.
#1 I was sidelined from life too.
For most of us, fatigue is a difficult condition to quantify and describe. We’ve all been “tired” before; but we rest, catch up on sleep, take better care of ourselves, and rebound.
Yet, Fatigue is the number one reason that people seek medical attention.
I’ve been there, and it’s what brought me here.
Like most of you, I was not only “tired,” I was wiped out. As a college student, I was absolutely exhausted. I could barely keep up with my studies at Rutgers University. Full weekends passed without any social interaction—I spent them sleeping. In essence, I was “benched.”
It was only by chance that I discovered my fatigue was the symptom of something bigger and potentially more troubling than simple “tiredness.”
I always had an interest in Naturopathic Medicine, even while studying finance at Rutgers. Changing my life’s path, I made my way to Bastyr University to obtain my degree in Naturopathic Medicine. While there, and still experiencing bouts of deep fatigue, I happened upon a book, Chronic Fatigue Unmasked. It opened my eyes.
All my symptoms were there and explained: profound fatigue, gastrointestinal issues, chronic illness. The list went on.
After graduating with a degree in Naturopathic Medicine from Bastyr, I came to Clymer Healing Center. The book’s author, Dr. Gerald Poesnecker, was the director here. He became my mentor as I completed my residence with him.
I have an intensely personal interest in the study of fatigue. In the video below, I share my own emotional journey with Adrenal Dysfunction.
#2 Can you relate to these symptoms?
When you’re more than just “tired,” it affects every area of your life.
Your family misses you. Your spouse doesn’t understand where his partner went. Your career suffers. Financial consequences pile up.
Sometimes even taking care of yourself seems impossible. And, oh, how much you’d like to be able to do something as simple as take your kids to an afternoon movie… or just cheer from the sidelines at a hockey game.
Ever hear, “Yeah, I’m tired, too, but I have to work,” or a similar comment from a friend or family member?
Or the ever-popular, “It’s all in your head.”
Perhaps, you’ve heard that you should just get some exercise, eat some red meat, or go to a therapist.
These unfortunate, ignorant comments come from people—often well-meaning—who simply don’t get it. It is not a choice. You cannot physically or mentally push yourself any further.
Once you’ve hit that wall, so to speak, you seek help. After all the run-around, the referrals to specialists, the lack of any real answers, people then find me. They have no choice but to get some help. The fatigue is just that overwhelming.
Adrenal Fatigue is a condition that is difficult to understand. Even those that are going through it, even after it’s explained to them, don’t quite “get it” for a while. And they’re the ones experiencing the symptoms on a daily basis.
It may seem like you’re just “tired,” but there’s much more to it. It’s unfortunate, but most doctors don’t know this.
#3 Why good doctors miss clear signs
So, you’re in bed more than you’re out if it. You’re waiting for it to pass, for the rebound, for the crash to end.
But what happens when there’s no rebound? When there’s no gas left in the tank? And what happens when your general practitioner can’t find anything “wrong” with you?
These are the patients that find their way to me. They are simply unable to “rebound,” and it affects almost every aspect of their lives.
Conventional doctors rarely understand this profound fatigue. Aren’t they supposed to have an intimate knowledge of the body’s physiology?
It’s relatively common for my new patients to plop down binders and folders full of entirely “normal” test results on my desk from some of the most exclusive world-famous clinics in the country.
I’ve come to the assumption that no one has a grasp on Adrenal Fatigue, and I am occasionally and pleasantly surprised when someone does or even tries.
My patients say to me, “I’ve been everywhere. Tried everything. Everyone and everything here says I’m normal, but why am I still so tired?”
Conventional doctors are trained in assessing and treating the disease, not the dysfunction.
They often miss subtle changes in blood work, which, had the changes been caught and addressed sooner, would have prevented disease.
Should your blood work or testing land in the normal range—or close to it—these doctors will chase your symptoms. While they’re busy putting Band-Aids on your symptoms, the root of the dysfunction is creeping its way into disease.
#4 The misery of the specialist merry-go-round
There are hundreds of conditions and situations that can lead to excess fatigue. What we as physicians are trained to identify are the underlying causes of disease, and in this case, the underlying cause of fatigue.
As I stated above, however, your conventional GP will chase your symptoms and never get to the bottom of your exhaustion.
How do they go about addressing your fatigue?
- They poke, prod, scan, and scope every part of you.
- You’re sent to specialist after specialist.
- They suggest psychiatric medication.
And then what? Nothing’s changed. You’re still exhausted, and you’re a bit lighter from all the blood they took.
The NIH reports that 20% of Americans are tired enough that it interferes with the activities of daily living, such as shopping, cooking, cleaning, grooming, etc. But Adrenal Fatigue is considered a “pre-disease,” and warrants little concern.
If you were to ask your doctor about the extremes of Adrenal Fatigue—Addison’s disease on one side (complete adrenal failure) or Cushing’s disease on the opposite (pituitary tumor leading to over-stimulation of the adrenals)—he or she would be able to understand, describe, diagnose, and treat you.
Anything short of those two incredibly rare conditions, and doctors will tell you that your adrenals are “working fine.”
Have you been tested and fallen short of these major and challenging diseases? Thank goodness! But should you be told that you should simply “get some rest?” No.
#5 The evidence is everywhere
I am convinced that Adrenal Fatigue is the number one cause of fatigue in this country.
I have seen thousands of patients over the past 12+ years. I have dug my heels into researching every aspect of the adrenals and fatigue. Adrenal Fatigue is real, and it’s affecting nearly every system in our bodies.
I promise that this won’t turn into a science lesson, but there exists a well-accepted delineation between “Central Fatigue” and “Peripheral Fatigue.”
Central Fatigue is associated with the Central Nervous System (CNS) and the feeling of tiredness. This is caused by altered neurotransmitter levels and function, mitochondrial dysfunction, immune dysregulation, and oxidative stress.
Peripheral Fatigue is more associated with muscle fatigue and weakness: being physically tired, primarily as a result of mitochondrial dysfunction and hormone imbalances (adrenal, thyroid, gonads).
These differences are most important to those of us researching the underlying causes of fatigue, rather than to the average person who is just dog-tired. The underlying causal pathophysiology is important to physicians and researchers because it can lead to specific treatments if better understood.
If you were to scan the research and literature on central and peripheral fatigue, you’d find what I’ve found and use in my practice every day.
Fatigue is a tough thing to define scientifically. This is because of the subjectivity of “feeling tired.” Also, there is no direct test or marker for fatigue, although researchers are working on it.
In a nutshell, Adrenal Fatigue is the result of chronic, unremitting stress that overwhelms one’s genetic capacity.
#6 Feeling hungover without a sip of wine?
How does fatigue feel?
Since this is a highly subjective, multidimensional experience, it’s not the same for everyone. In general, it’s perceived as:
- Physical tiredness or exhaustion
- A need for reduced activity
- Reduced motivation
- Mental “burnout” or mental fatigue
Sounds like some fairly common symptoms, don’t they?
But it’s not simply a matter of needing to sleep. Fatigue can negatively affect every system in the body.
This was the experience for Chris, one of my patients here at Clymer Healing Center…
#7 Has your bucket runneth over?
I use a metaphor to help my patients understand Adrenal Fatigue and Dysfunction. In fact, I use it in many articles on this website. It’s the best way I know to give a clear picture of what’s happening in your body.
Our genetic capacity for stress is developed at conception and shaped throughout life, half from mom, half from dad. In utero, our adrenals get an idea of how stressful the outside world is through a shared circulation between mom and baby.
We are all born into the world with a certain size bucket of tolerance for stress, any stress.
We only have one bucket to deal with all kinds of stress. There is no separation of various stressors from one another.
Whether it be an injury, a chemical toxin, an annoying text message from your brother, or fear of debt, all stressors go into the same bucket, though some may be weighted more than others.
Our bucket holds everything! Until it can’t.
By design, this bucket was meant for extreme, acute stressors, such as a plague, famine, or a predator. If a tiger jumps were to lunge at you, your bucket would immediately and completely fill with “stress.”
Depending on the outcome of the experience with the tiger—if you lived—then your bucket will empty again and be ready for the next time.
The problem with living in our present society is that we now use our stress response bucket quite differently from its designed purpose.
Chronic, low-level stress comprises our world. We no longer have to fear for our safety from predators, no longer have to worry about starvation (most of us at least), and no longer deal with deadly plagues. However, we do fill our bucket with multiple chronic, perpetual stressors.
The list of chronic stressors is long and ever-changing, and you likely know your list better than I do. We are bombarded by so much constant stress these days that our bodies have acclimated to it, as you would adjust to feeling your watch after only a few minutes of wearing it.
When you remain in this stress response too often—whether your mortgage is past due or you’ve got some tigers in your neighborhood that I don’t know about—your body compensates. But when it compensates for too long, this over-activates the organs of stress and shuts down the organs of relaxation (such as those in your immune system and digestive systems and those of reproductive and thyroid function).
This is Adrenal Fatigue.
#9 Your adrenals are stuck in the stone age, and you’re paying the price
While the body is busy “fighting tigers” and suppressing energy metabolism, the chronic stress physiology also suppresses the rest and digest organs, including but not limited to the digestion, immune system, reproductive system, and thyroid.
This makes physiological sense. If you were running from a tiger, you wouldn’t want an ounce of your energy going anywhere else.
Each of your major organ systems is related to the production of energy. If one or more of them are suppressed due to Adrenal Fatigue, no wonder you’re so exhausted.
The short version? Fatigue = Low Fuel
Energy production boils down to the body’s ability to convert fuel into the commonly used form of energy in the body called ATP. This process occurs within the mitochondria of each and every cell in the body. The mitochondria are referred to as the batteries of the cells, and collectively the battery of the body.
Dysfunctions on both sides of the physiologic seesaw (the balance between fight-or-flight and rest-and-digest) eventually lead to multiple pathways disrupting this multistep, energy production process.
When the body is in a chronic stress response (aka fight-or-flight or sympathetic overdrive), multiple physiologic effects occur.
- An overutilization of fuel and nutrients
- An overproduction of free radicals leading to oxidative stress
- Dysregulated sugar and energy metabolism (mitochondrial function)
- Neurotransmitter dysregulation
- Decreased blood flow to the brain and peripheral muscles
All of these physiological breakdowns due to Adrenal Dysfunction lead to systemic dysfunction. Your digestive, immune, and thyroid are all compromised!
And guess what? That’s why you’re exhausted.
#10 Digestive and immune symptoms that add to your fatigue
Adrenal Fatigue affects all the systems of your body, particularly digestive, immune, and thyroid function. And guess what? Dysfunction of any kind will add to your overall fatigue.
Symptoms of Adrenal Dysfunction that manifest in the digestive system:
It also affects our immune system. We become more vulnerable to infection thus leading to low-level chronic infection, which acts as an energy drain.
There is also an increase in our antibody production, and our bodies overreact to innocuous substances in our environment, and our energy depletes even more as our bodies waste energy on attacking things like gluten or pollen.
There is a shift in our cytokines, which are like the hormones of the immune system (tiny chemical messengers that tell the body what to do and how to do it), and this imbalance creates low-level inflammation. This feels like chronic pain and saps your energy even more.
The cytokines also trigger inflammation and reactivity in the Central Nervous System (CNS), and this neuroimmune activation is a major contributor to the central fatigue and pain.
This process leads to these immune-related Adrenal Dysfunction symptoms:
- Food allergies
- Environmental allergies
- Chronic sore throat
- Low-grade fever
- Frequent illness
- Recurrent infection
- Chronic sinusitis
- Post-nasal drip
- Ear infections
- Pain and inflammation
#11 Adrenal Dysfunction = Thyroid Disorders = Fatigue
The thyroid is well-accepted as being the engine of the body, driving energy and metabolism. The suppression of this function due to chronic stress and Adrenal Fatigue is an effort of the body to slow down.
A suppressed or underactive thyroid leads to decreased energy levels at all levels. It causes both central and peripheral fatigue. (By the way, your thyroid hormones values don’t have to be frankly low to have suppression of function.)
This also leads to symptoms of:
- Weight gain
- Cold hands and feet
- Frequent bruising
#12 How to wake up with energy
To be free of fatigue, we heal the adrenals. Plain and simple.
The most important treatment for Adrenal Fatigue is healing from the ground up.
- Not chasing symptoms without identifying their root causes.
- Reviewing testing with a more discerning eye, an eye towards trends and dysfunction.
- Paying close attention to the subtle changes in blood work.
- Understanding that, if left unchecked, dysfunction will lead to full-fledged disease…and treating it before it does.
- Controlling your symptoms while focusing on healing the dysfunction at its root.
- Identifying and treating disease, but also looking for trends of dysfunction (pre-disease, if you will).
The bottom line…
In over a decade of seeing thousands of patients both in my office and via telephone or Skype, I have discovered that once someone has Adrenal Fatigue and Dysfunction, the physiologic shift that occurs comprises all primary causes of fatigue.
Many well-educated and well-intentioned doctors will focus on these individual causes of fatigue: low thyroid, low testosterone, mitochondrial dysfunction, chronic inflammation, oxidative stress, allergies, chronic infection, irritable bowel syndrome, etc.
But it’s time to tie them together for successful and lasting treatment!
It is a mistake for doctors, both conventional and alternative, to focus on only one part of this dysfunctional process.
The primary goal must always be to treat the underlying Adrenal Fatigue and chronic activation of the stress response. Failure to do so wastes your precious resources of time, money, and most important, energy.
The challenge is that fatigue takes many shapes and has many names. Some call it tiredness, malaise, lethargy, listlessness, lassitude, or just exhaustion. Others call it post-exertional malaise, weakness, or chronic fatigue. The other challenge is that fatigue also exists on many levels and affects many systems of the body leading to a diversity of symptoms.
Once the underlying Adrenal Dysfunction is properly assessed and treated, it’s as if the all the other systems of the body can come to life again. And this is when your fatigue will dissipate.
As I mentioned at the start of this article, I have an intensely personal interest in the study of fatigue. In the video below, I share my journey with Adrenal Dysfunction.