Adrenal Fatigue Library

Who Is Susceptible to Adrenal Fatigue?

Written by Dr. Andrew Neville

People develop Adrenal Fatigue due to some variation of a combination of genetic susceptibility and stress over time. While it can develop in anyone, some are at more risk than others. For the purposes of this article, there are three main “categories” of people, and one is less susceptible than the next.

First, there are those who are genetically strong. If I compare the genetic adrenal strength to a bucket, these people are born into the world with a barrel, a huge tolerance for stress. These people have a tremendous capacity for stress, genetically, and tend to be the people who, in their 90s, continue to smoke and drink all in good health. These people will typically avoid Adrenal Fatigue for the most part, unless they suffer significant amounts of trauma, tragedy, and chronic perpetual stress, enough to overwhelm even their large capacity. This category of people is dwindling in number.

How Much Stress Can We Handle?

On the other end of the spectrum, I see people who were born into this world with a weak stress response system or “weak adrenals.” Rather than a bucket, they were born with a thimble for stress capacity. In fact, research now tells us that the stress levels of the mother during pregnancy can predict the stress-related conditions that the child will develop later in life. These people will typically be sick or colicky from an early age, they can even be born premature. They will have allergies as a child and be paler and weaker in constitution. Unfortunately, these people will need care in controlling their exposure to stress throughout their lives. This category is growing in number.

Between these two extremes is where the majority of people lie. Most of us are born into the world with an average-sized bucket. There needs to be some adequate combination of genetic weakness and chronic stress that contributes to a breakdown of this system, enough that eventually cause Adrenal Fatigue symptoms. Childhood trauma and tragedy, such as emotional or physical abuse, put a tremendous strain on this system and hinders the normal development of their stress response.

Certain personality types are also at increased risk for the development of this condition. These include “Type-A” personalities, adrenaline junkies, caregivers, people-pleasers, the empathetic, overachievers, and perfectionists. Also, people who are more caring and more sensitive are simply more likely to fill up their bucket faster. These types of people will place undue stress on their system because of their nature; they must address the underlying causes of these behaviors to be free from this condition.

There is some good news, and it’s that the vast majority of patients can be helped with the appropriate treatment.

“How do I know I have it?”

Once there is a suspicion of Adrenal Fatigue, the next step is to assess it. There are several different ways to assess adrenal hormones, and all have merit. Testing can be done through the blood, urine, or saliva; however, only through the saliva can you reveal the temporal (daily) patterns of cortisol secretion.

Salivary adrenal hormone assessment can accurately measure not only cortisol but also DHEA and other important parameters of Adrenal Fatigue. Armed with this information, you can accurately determine the exact phase and stage of dysfunction of the individual patient.

Proper interpretation of testing is nuanced

This assessment phase is a crucial step in the process and should not be overlooked. While it may be easy to assume a person has Adrenal Fatigue based on their clinical appearance (symptoms), determining the exact phase of dysfunction accurately is quite challenging given the amount of symptom crossover in the various phases.

Assessment is vital because the treatment differs depending on the person’s phase at that time. Changes within the endocrine system  receptors on cells respond to even nanogram changes (this equates to 1 millionth of a gram!) in hormone levels in the blood.

Accurately and precisely understanding the nature of each individual as well as the levels of their various hormones is necessary.

 “So, what do I do about it?”

For treatment of the conditions that develop from this imbalance, we must assess and reduce the triggers that caused the stress response. We must also work to support, nurture, and balance the actual stress response system itself.

Paying attention to the resultant or secondary effects of a chronically activated stress response system is essential. These secondary effects of increased free radical production and imbalance of oxidative stress, methylation defects, mitochondrial dysfunction, and impaired detoxification must sometimes be assessed and treated, as well; although, as these effects are secondary in nature, the focus should be on the stress response system itself.

I am consistently amazed at the dysfunction and symptomatology that improves when we effectively address the stress response system itself.

When approaching Adrenal Fatigue from a naturopathic perspective, I look towards two major objectives:

  1. Remove the obstacles to cure 
  2. Reestablish the basis for health

Patients must try to keep these two objectives in mind in every aspect of their life. Every action, habit, behavior, or thought is helping to move them in the direction or health, or they are doing the opposite and acting as an obstacle. Identifying and working at this level will have lasting effects far beyond symptom resolution.


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