Family, food, gifts, and fun are all part of the joy of the holidays for most people. For many, fatigue is also a part of the holiday season. Staying up late for holiday parties or the stress of finding a last minute gift can wear a person down; but what if the tired and worn out feelings persist beyond the holidays? In cases like this, a busy schedule may not be to blame. It may be adrenal fatigue.
Adrenal fatigue occurs when the adrenal glands can no longer produce enough adrenal hormones and neurotransmitters for optimal function. This happens when stress has been constant.
Adrenal fatigue can be divided into three stages:
- Early-stage: This stage is the body’s normal response to stressful events such as hosting a holiday party or finding the perfect gift for that difficult family member. Early-stage (Figure 1) is characterized by elevated levels of epinephrine, norepinephrine, cortisol, and DHEA, and serotonin levels may be optimal or imbalanced. Often, the clinical presentation in early stage includes overstimulation, anxiousness, sleep disturbances, trouble focusing, and feeling stressed. In a healthy situation, the body will be able to recover with a little relaxation. However, when stress is chronic, like the difficult family member moves in next door, adrenal fatigue can progress to mid-stage.
- Mid-stage: DHEA, epinephrine, and norepinephrine can appear variable in the mid-stage of adrenal fatigue and serotonin starts to become depleted in this stage (Figure 2). Cortisol is dysregulated as shown by any of several patterns, including an “L-shaped” curve where levels are low in the morning and elevated in the evening. Clinically, individuals in mid-stage adrenal fatigue are often “wired and tired” (indicating both anxiousness and fatigue) and have low mood.
- Late-stage: In late-stage adrenal fatigue, DHEA, cortisol, epinephrine, norepinephrine and serotonin levels are typically low (Figure 3). Symptoms common in late-stage adrenal fatigue include fatigue/exhaustion, difficulty dealing with stress, cognitive decline, and weight management difficulties.
Adrenal fatigue occurs over time. Addressing issues in the early stages is helpful, and lifestyle changes to reduce stress are also beneficial. Testing adrenal hormone and neurotransmitter levels can help a practitioner determine what therapy will be most beneficial to support adrenal activity as opposed to just treating symptoms.