PART 1: ADRENAL FATIGUE IS REAL
Dr. Krista Coombs, DrAc, IFMCP
August 1, 2025
In this week’s INSIGHTS for Healing by Design, I’m sharing Part 1 (of 3) of my Adrenal Series, where I describe the fundamentals about the contested concept of ADRENAL FATIGUE. It is not a myth. It is a real occurrence that plagues especially women as they navigate hormonal chaos at various points of their lives. See if what I describe applies to your YOUnique experience right now. And I promise, in Parts 2 and 3 you will find solutions.
Adrenal fatigue, or what I tend to call it, adrenal dysfunction, is your body’s logical reaction to chronic stress, exposure to toxins, and hormone chaos. Your biology gets overwhelmed as it tries to adapt as best it can with the inputs it’s given. This extreme efforting eventually leads to breakdowns in production and communication.
And it is more common than you may have been led to believe.
🥱Staring at the ceiling since 2:57 am.
Again.
Replaying conversations in your head from 2005.
Considering taking a sleeping pill but it’s maybe too late in the morning for that now, sigh…
Then, in a half doze, having to drag yourself out of bed at 7 am, feeling like you’ve been hit by a truck, and coffee just can’t get the engine roaring before work begins.
Fighting to stay awake mid-afternoon, not quite able to fully focus on the meeting at hand.
And nighttime? Now you’re wired and anxious, with your brain buzzing like a mosquito you can’t find, snapping at the cat for meowing too loudly.
I’ve experienced periods of time like this during burnout - related to adrenal fatigue/dysfunction, and I’ve heard similar stories from countless female patients over my decades of medical practice.
Typically, they’ve been told all the same things – you need more sleep, meditate more, you’re just getting older and this happens, or it’s all in your head. Sigh… I think my favorite response though is that their bloodwork looks normal! Ridiculous! I can always find something…
If you’ve experienced this type of progressive burnout, please know that you are not broken and you can recover. You just need some intelligent redirection, not band-aid responses.
There are no quick-fixes available for recovery from adrenal fatigue.
Gatorade or electrolyte elixirs will not cut it even though they can feel good at first. Iron supplements and adaptogen herbs won’t be enough long term either. These are band-aid care only.
Yet, there are ways to address this chronic degradation of body systems if you’re willing to expand your mind on the topic and change how you approach your body.
WHAT ARE YOUR ADRENALS, WHY THEY MATTER
Your two walnut-sized adrenal glands, on top of each of your kidneys, are considered the over-achievers of your endocrine system (hormone secreting system).
They might be tiny but wow are they an incredible crisis management team and hormone conductors!
Your adrenals produce some of the most important hormones your body needs, including (but not limited to):
CORTISOL – helps regulate sugar levels, blood pressure and your body’s response to stress, plus is involved in metabolism and suppression of the immune function.
ADRENALINE (epinephrine) & NORADRENALINE (norepinephrine) – essential for the “fight or flight” stress response, increasing heart rate, blood pressure and blood sugar levels when stressed.
ALDOSTERONE – helps the kidneys retain sodium and water and excrete potassium to impact blood pressure.
DHEA – converts to some of your body’s family of testosterone and estrogens (some also made at ovaries in women, testes in men), therefore, important in reproduction, sex characteristics but also impact all systems in the body (brain, heart, liver, gut, muscles, immunity, lungs, etc).
PROGESTERONE – small amounts of this steroid hormone are made in adrenals that influence reproduction, but like DHEA and its hormone metabolites, impacts all organ systems beyond reproduction (most is made in the ovaries of women on a cyclical schedule).
DOPAMINE – this neurotransmitter influences blood vessel relaxation and constriction, salt removal, reduced insulin production at pancreas, slows gut movement, helps with memory, movement, pleasure, mood, learning, and sleep (majority is produced in the gut by microbes).
When your life is relatively chill, your adrenals hum along in the background, managing your metabolism, keeping blood sugar stable, influencing reproduction, and helping you sleep at night.
But when stress starts stacking up and becoming non-stop pressure – think, work pressures, relationship issues, trauma, mold exposure, parasite overload, EMFs, autoimmunity, injuries and more… your adrenals begin pumping out cortisol like it’s a life jacket.
And they don’t stop… because they can’t or you’ll crash.
Our biology is AMAZING! But, it simply wasn’t built to handle non-stop stressors that have unfortunately become the norm of modern living.
The body evolved in environments where short sprints for survival were the norm, not marathon after marathon that become burnout.
➡️ So, when the adrenals are over-taxed from performing like the crisis management team they are, but for too long, the communication with the body’s many systems start to glitch and collapse.
They aren’t failing though (unless true autoimmunity is at play, which is rare). They are simply SCREAMING for support and few of us listen.
ADRENALS & THE HPA AXIS
Your adrenals do not operate separately from the other organs and tissues in your body. They are part of a much bigger system called the HPA Axis – the Hypothalamus-Pituitary-Adrenal Axis (which actually is part of an even bigger system of interacting organs and glands).
➡️ This HPA Axis is very significant. It’s basically your body’s internal command chain for managing any stress that pops up in your life.
The chemical response to a stressor begins in your brain at your amazing hypothalamus gland. It detects a stressor – which could be physical or emotional or environmental – and hormonally signals your pituitary gland (the Master Gland), which then hormonally signals the adrenals to release a bunch of hormones, such as the famously known cortisol.
This hormone cascade is a feedback loop of chemistry, designed to try to keep you safe. What should happen is the messages to the adrenals lead to an appropriate hormone response that then feedback to the hypothalamus and pituitary glands that the stress is past and now we can recover.
When this axis is not over-worked, it fires quickly, then takes time to recover.
➡️ But when your body is constantly flooded with stress signals, over long periods of time, the HPA Axis can get stuck in overdrive and the communication between all the major players starts to break down.
The hypothalamus eventually may stop detecting stressors as accurately or efficiently.
The pituitary’s response may become more sluggish too.
And finally the adrenals get resistant to being yelled at so continually, and stop responding as efficiently.
This ends up becoming a cortisol pattern that is not the normal, healthy pattern. It becomes more like static noise than beautiful music, which leaves you wired but foggy and exhausted, and confused about why nothing is helping anymore.
ADRENAL FATIGUE IS REAL
If you’ve ever asked your traditional doctor if what you’re experiencing is adrenal fatigue, I’d bet 9x out of 10, you’ll get an eye roll and have the term dismissed as not being a real thing.
Technically, it’s true, there is no one lab test to prove its existence.
But, the breakdown in the HPA Axis IS a real thing and the term fatigue or at least dysfunction is an adequate way to describe the condition that shows up as the symptoms you feel.
The traditional medical world does recognize Adrenal Insufficiency, however, which includes the rare autoimmune condition, Addison’s Disease, where the adrenals are attacked and damaged, as well as Secondary Adrenal Insufficiency, caused by hypothalamus and pituitary issues. These are serious, life-threatening conditions that can be diagnosed with ACTH (adrenocorticotropic hormone) stimulation tests and then treated with hormone therapies.These conditions are not what most people are dealing with when we say Adrenal Fatigue.
Instead, Adrenal Fatigue feels like being a hollowed-out version of yourself that does not respond to just eating a little better or a good night’s sleep.
You’re tired when you wake up, wired when you need to be winding down in the evenings, constantly craving salt and perhaps sugar, and emotionally hanging on by a thread.
It’s a functional depletion of the adrenals, or other ways to put it, adrenal burnout and adrenal dysfunction. It’s a breakdown or fatigue with adrenal communication with the hypothalamus and pituitary glands in the brain. AND, by the way, this poorer communication issue can eventually interrupt quality responses to and with the thyroid and ovaries (also endocrine glands), causing major breakdowns throughout the whole body.
Your brain and adrenals (and then sometimes thyroid and ovaries) are out of sync and stress hormones no longer show up for stress on time or at all anymore.
Communication breaks down.
JUST REMEMBER:
Adrenal fatigue is not a disease.
It is a dysfunction.
And it’s manageable.
In Part 2 of my Adrenal Series, released next week, read about the root causes for adrenal fatigue and start uncovering what may be impacting your adrenal dysfunction.
Then in Part 3, released in two weeks, learn how you can test for adrenal fatigue and then start resolving the dysfunction with actions you can take right away.
😴 Now, go get some proper rest.
Hugs,
Dr. Krista
DrAc, IFMCP
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