You have been told by your functional medicine practitioner that you have adrenal fatigue symptoms and the 4-point cortisol saliva test shows that you are definitely experiencing adrenal fatigue. You have instituted the recommendations to bring you out of this insufficiency, but some how, you still do not have the energy you would like to have.
Ideally, your follow-up 4-point cortisol saliva test results will show an improvement in about 6 months after making the recommended lifestyle changes, but some times it can take up to 18 months. You should definitely see a gradual improvement in test results and an improvement in symptoms.
As you improve, you will have:
- More energy in the morning and afternoon
- Deeper and more restful sleep
- Better moods
- Improved skin conditions and less dry skin
- Less brain fog and better memory
- No dizziness upon standing
- Less hormone swings, including improved PMS
- Decreased food cravings or completed eliminated
Potential Reason Why You May Not Be Improving?
- Eating too few calories
- Carbohydrate deficient
- Still stressed
Let’s dive deeper into these reasons:
- Eating too few calories: when the body perceives starvation (eating too few calories), it is trying to anticipate a future shortage and so it down regulates thing like muscle building, fertility, energy, and immunity. Your metabolism begins to slow down in order to keep you alive and your hormones down regulate and blood pressure decreases. This is your body’s ways of keeping you alive (slowing down everything). This is similar to adrenal fatigue in terms of hormone production. Just as with starvation, in adrenal fatigue, cortisol and DHEA (adrenal hormones) and thyroid hormones become imbalanced. During starvation, micronutrients, e.g. magnesium are less available. Magnesium, for example is a very important micronutrient required in 600 processes in the body. If this micronutrient is deficient, metabolic processes are stalled. And, of course, we have many other micronutrients that are required in all of our metabolic processes, to carry out life, but the truth is, macronutrients (where we get our calories from), is what our bodies really run on, and many people are too consumed with quality of their diet verses quantity. Quality is important, but not to the detriment of quantity. Our bodies expend energy supporting the processes of life (digestion, heart beat, brain activity, respirations, and more). We expend energy through physical activity and movement. The energy we use is measured in calories, and these calories do matter. People understand how much these calories matter when too much is consumed, but are less aware of what it means when too few calories are consumed. We need enough calories to assure our metabolic rate is met, thus knowing how many calories this is for you, is important to know so you don’t put yourself into starvation mode, and reduce your metabolic rate. To assess your metabolic (basal calorie needs) rate, go HERE.
- Eating Too Few Carbohydrates: Everyone has different genetics and epigenetics, gut flora and hormone patterns that predispose them to a certain level of carbohydrate need in the diet, at a particular time in their life cycle. Thus, following the fad diet of the day, e.g. keto diet, or overall low-carbohydrate diet, may have worked for you at one time, but may not be the best for your specific needs now. Because those with adrenal issues most often also have thyroid hormone issues, adrenal fatigue will only increase any pre-existing thyroid issues. However, if adrenal fatigue improves, often the need for thyroid support is corrected and no longer indicated. Carbohydrates play into this because when we reduce carbohydrates in the diet, we are also reducing the conversion of our inactive thyroid hormone (T4) to the active thyroid hormone (T3). This will continue to disturb the HPA (hypothalamic-pitutitary-adrenal) axis regulation, and we know that cortisol (adrenal hormone) is important for blood sugar regulation. It is often recommended that for those in adrenal fatigue eat every 2-3 hours in order to keep their blood sugar levels stable. The need for cortisol to keep blood sugar levels stable increases if the carbohydrate content is either too low or too high. Cortisol is already out of balance with adrenal fatigue, so it is thought that reducing the demands on cortisol will speed healing. So, the amount of carbohydrates you need, will require experimenting with the levels that begin to have you feeling better. So, for those struggling with adrenal fatigue, you may need to increase your carbohydrate intake to at least 150 grams a day and maybe higher. I recommend you keep a journal that tracks how you feel with the amount of carbohydrates you are consuming. Avoid too many carbohydrates all at once. Instead, spread them out throughout the day. Based upon how you feel, will determine the amount of carbohydrates that are best for you. Give it at least 7 days to test at each carbohydrate level. This is subjective and you will want to pay attention to how you are digesting, how you are pooping and also testing your blood sugar.
- You are still stressed: Stress is not necessarily just what you perceive as stress. Your body may be disagreeing with you and you are not yet aware of how your body perceives the world. Perhaps you have gut issues you are not aware of, or a viral infection. Or perhaps you have reduced the number of hours you have worked from 80 to 60 hours a week (if so, great), but your body says that is still not enough hours to reduce it to in order for you to heal. Or, perhaps you got out of a toxic relationship and things are improving, but your body is just not quite healed yet (but give yourself credit because you have come a long way). Again, keep a journal on what triggers your body into the fight or flight mode. Track your heart rate and energy swings and any anxiety around your life. As you become more aware of the triggers, you can better deal with them. I speak to many clients who are convinced they are not stressed, but unfortunately, their bodies are disagreeing. Understanding this is crucial to your healing.
So, let’s say you have corrected all three of these issues (you are getting enough calories, you have balanced your carbohydrates and your stress level is better balanced, but you are still having adrenal fatigue issues (assessed by your symptoms and unchanged lab results). Then it is time to reassess the program that you are on. Perhaps at this time in your life, this is the wrong program. Or perhaps you need to reassess your gut and hormone presentations. There is always a reason and a root cause. We just need to keep digging.
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