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The Truth About Adrenal Fatigue or HPA Axis Dysfunction

Written By Deidre Bloomquist

You’ve probably heard the term adrenal fatigue before, but what does it look like and what does it really mean?

Is adrenal fatigue real?

We know that CrossFitters put their bodies under a unique amount of stress by combining high-intensity and heavy weights, and understanding what that stress can do to our body in combination with internal stressors is important for providing adequate support to recover and continue making progress in the gym.

HPA AXIS & HOW IT WORKS

It’s first important to understand how your HPA (hypothalamus-pituitary-adrenal) axis works to connect your central nervous system and endocrine glands. When we understand how our body is meant to work, it’s much easier to know what signs and symptoms tell us about how the system is working as a whole.

The HPA axis is made up of your hypothalamus in the brain, the pituitary gland within the hypothalamus, and your adrenal glands which sit on top of your kidneys. The HPA axis is responsible for creating the neuroendocrine component of the stress response.

When our body and brain interpret something as a stressor, a stress response is initiated. This response is characterized by the release of corticotropin-releasing hormone (CRH) from the hypothalamus. CRH binds to receptors located in the anterior pituitary, triggering the release of adrenocorticotropic hormone (ACTH). In return, ACTH stimulates the release of cortisol in the bloodstream by the adrenal cortex.

Under normal circumstances, the hypothalamus and pituitary are able to sense when there are adequate levels of cortisol in the bloodstream and alter the amounts of CRH and ACTH being released to regulate cortisol accordingly as needed based on stressors.

WHEN IT GOES WRONG

When stressors are chronic or do not cease, cortisol levels do not come down and this negative feedback loop is unable to be achieved, meaning that cortisol remains at high levels in the bloodstream for prolonged periods. Healthy cortisol levels ensure that the hypothalamus and pituitary glands maintain the appropriate level of sensitivity to cortisol in the negative feedback loop.

A man with adrenal fatigue working long hours at his office.

Oftentimes, this type of fatigue is correlated with external stressors in our life, which include work and life stress, lack of sleep, or exercise. Adrenal fatigue has become a hot topic and buzzword in recent years, however, it has not been recognized as an actual medical condition based on the symptoms typically recognized for adrenal fatigue.

This does not mean that adrenal dysfunction is not real. Hypoadrenia and hyperadrenia describe the body’s ability to produce adequate levels of cortisol, by either being in excess (hyperadrenia) or lacking (hypoadrenia). Dysfunction is common and often a result of underlying health issues existing the interwoven systems of the body, including the liver, pancreas, or small intestine, and poor sleep habits do play a role.

When cortisol levels are chronically low, you might experience:

Chronic fatigue and never quite feeling awake naturally
Slow or lack of results in the gym
Weight gain or stubborn weight loss (especially around the midsection)
Chronic SI and back pain
Energy and mood crashes throughout the day
Reduced stimulant effect from caffeine

On the other hand, when cortisol levels are high, you might experience:

Increased athletic injuries
Reduced production of melatonin and the ability to fall asleep naturally
Compromised immune system
Blood sugar dysregulation
Increased levels of free fatty acids in the bloodstream
Unwanted weight gain

WHAT DOES THIS MEAN FOR ATHLETES?

Imagine this: You’re a CrossFit athlete, hitting a WOD 5-6 times per week, possibly with extra work before or after the main event in the form of accessory work, additional weightlifting, or gymnastics skill work. You’re active on the weekends, and hold a regular job that requires you to be up early or stay up a bit later to get your workout in.

You have some underlying gut health issues, and while you’re not sure if you have any food allergies or sensitivities, you haven’t dug into what’s going on there. You might experience energy or mood crashes between meals, so you find yourself snacking regularly or making small meals to eat every few hours. Your sleep is limited and you are dedicated to making every 5am class regardless of how tired you might be.

A female CrossFit athlete dealing with Adrenal Fatigue.

You feel better after you eat, but about an hour later, your energy levels crash and you’re tired again, so you reach for coffee throughout the day. If you’re a trainer, you might even be drinking coffee from 5am through the evening and you can get to sleep right away since the caffeine doesn’t seem to have the same effect it used to.

This happens pretty often for CrossFit athletes, and is often a sign of hypoadrenia (low cortisol levels). While your low cortisol might be the issue grabbing your attention, it’s likely resulting from a much deeper cause revolving around your body’s ability to regulate insulin levels and your blood sugar based on your diet or the health of your microbiome causing internal stress on the body and secreting excess cortisol as a way to help keep you feeling good and moving forward.

When you are able to step back and get to the root cause and what is causing your adrenal dysfunction, you can resolve high or low cortisol levels in a natural and sustainable way.

Oftentimes, athletes are forced to slow down when their body is unable to take the stress any longer and unable to mitigate cortisol levels are chronically low (or high) levels.

It’s important to note that in recent years, adaptogenic herbs have become popular in the fitness community as a supplement to help your body cope with the internal and external stressors to better regulate cortisol levels. While these can help when taken, they are not addressing the real cause of the stress. By resolving the internal stressors causing cortisol dysfunction, adaptogenic herbs will be unnecessary.

A female athlete getting adrenal fatigue treatment.

WHAT TO DO WHEN YOU THINK YOUR CORTISOL LEVELS ARE HIGH/LOW

Whether you think your cortisol levels may be high or low, many of the same protocols can help provide reduced stress to the body to heal the system(s) causing cortisol levels to be irregular. Some of the nutritional and lifestyle changes that promote adrenal health from the inside out include:

Prioritize sleep and resting. Aim to get between 8-10 hours of sleep a night, and keeping a consistent schedule is important to maintain an internal clock.
Stay hydrated, and don’t forget about electrolytes. The adrenals sit directly on top of the kidneys, and hydration plays a key role in their function. Without enough electrolytes, water is unable to be utilized and passes directly through our system, so adding an electrolyte supplement, salt, or lemon to your water can help retain water at adequate levels.
Avoid junk food and hydrogenated oils that create inflammation in the body and particularly in the gut.
Find a balance between your macronutrient consumption, getting plenty of protein daily, without too many carbohydrates with fat. Eating too many carbs increases blood sugar levels, and insulin levels as a result, and can lead to insulin resistance and hormone dysregulation.
Incorporate a wide variety of nutrient dense foods into your diet to promote healing and gut health.
Consider reducing or removing caffeine as it may be affecting your body’s natural ability to regulate cortisol levels and maintain a natural circadian rhythm.
Practice moderate exercise methods to reap the benefits of exercise while avoiding adding stress to your body while you heal. This might mean reducing cardiovascular movements and focusing on resistance training, but work with a trusted fitness professional to determine the best plan for you.
Consult a healthcare practitioner about taking adaptogenic herbs and supplements to find out if they may be helpful for you.