Running on empty

by Nicky Pellgrino / 02 July, 2015
It’s a diagnosis that explains many symptoms of modern malaise, but is adrenal fatigue a real thing?

Adrenal fatigue is a medical hot potato. It’s an appealing diagnosis in a way because it explains so many common niggles: fatigue, weight gain, sleeplessness, headaches, that sense of swimming through syrup as you struggle through the day.

Some say such symptoms can be put down to the adrenal gland, which is so exhausted by the pace of modern life that it’s stopped proper production of the get-up-and-go hormone cortisol. Trouble is, the medical profession maintains there’s absolutely no evidence that adrenal fatigue exists.

The adrenal glands are rather small things to be causing so much trouble. We have two of them, located on top of each kidney, and they’re responsible for producing several of the hormones our bodies need to function properly.

Auckland integrative health practitioner Kathleen Wills, author of Beat Burnout (Wild Wolf Press, $29.95), says she sees adrenal fatigue in eight out of 10 of her clients. “It isn’t just one particular type of person – it could be athletes, entrepreneurs, at-home parents, teenagers, children. Often the elderly are affected.”

It’s the stressful way in which we live that’s to blame, she says. Kids have lives crammed with extra-curricular activities; adults are slaves to smartphones and laptops, juggling busy, pressured roles at work and at home, pushing themselves to the limit at the gym and not taking enough time to rest. As a result, the normal pattern of cortisol production is disrupted. Instead of being at its highest in the morning and lowest at night, cortisol levels continue to rise throughout the day, meaning it’s difficult to sleep and a struggle to get up when the alarm goes off. We can become depressed, or dependent on stimulants such as coffee and energy drinks to keep us going.

“If you don’t treat this adrenal-fatigue condition, it can worsen and you can end up not being able to get out of bed,” says Wills. She uses saliva or urine tests as tools to diagnose her clients and advises treating the condition with diet and lifestyle changes, plus herbal supplements and an adrenal glandular complex derived from pigs. By following this regime, she says the average person can recover in three to six months.

On the other side of the coin, endocrinologists argue there’s no science to back up such a diagnosis and no clinical data to show the treatment offered is either effective or safe. There are several adrenal-gland disorders – including potentially fatal Addison’s disease – but these are relatively rare and can be identified easily with a blood test.

“A surprising number of bad things can happen to an adrenal gland and it will still function in a way that’s compatible with normal health,” says Auckland endocrinologist Stella Milsom. She refers to adrenal fatigue as “an unproven pseudo endocrine diagnosis” and has concerns it may divert people from identifying serious conditions such as heart disease, diabetes and depression.

But what she and other endocrinologists are most concerned about are the hormonal supplements being offered by some complementary health practitioners. “They can be very potent, but you can’t be confident of the purity or the dose,” she says. “People may be given doses that are a lot more than the body would make naturally. In some cases they can shut down their own hormone production.”

Milsom refers to a raft of supplements being used to treat a variety of conditions, saying she sees a patient a week who has been harmed by this approach, including men who have developed fertility issues after taking testosterone supplements. “It kills the sperm,” she says.

Meanwhile, Wills argues that as a practitioner of integrative medicine she’s looking at prevention; she wants to catch patients before they start to suffer from significant disease and need to see an endocrinologist.

This is a debate that’s likely to rage on. However if adrenal fatigue really is a thing, the best ways to avoid developing it are to eat healthily, exercise moderately, get enough sleep, switch off your phone and tablet and take a walk outside and use up your annual leave. No one on either side of the medical divide is going to argue that these activities aren’t good for your health.

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