The term 'adrenal fatigue' has been wildly popular for nearly 20 years. In fact, the majority of patients and healthcare providers actually believe (unfortunately) that such a condition exists. Which is why so many people feel like they never get better. Spoiler alert: There is always one or more reasons WHY cortisol isn't being properly made, and it's not because your adrenal glands decide to quit playing the game!
Having done all the research, I can tell you this with 100% certainty:
Does low cortisol Exist?? YES....Is it because of 'adrenal fatigue'...Years of scientific research says absolutely not!
So if adrenal fatigue isn't a real condition, what causes cortisol levels to flatline? Read on to find out.
Cortisol is the body's primary stress hormone and is released in a 'circadian' pattern during a 24 hour day (high in the morning, low at night). This pattern of cortisol release controls every metabolic process and the actions of every single cell in the body...WITHOUT CORTISOL, WE WOULD DIE.
The hypothalamus in the brain is the main regulator of the stress response. During a stress response, the hypothalamus tells the pituitary gland to tell the adrenal glands to make cortisol (this is called the "HPA axis"). This pathway is VERY important in the proper production of cortisol.
All the research over the past 40 years has shown that when cortisol levels go down, it is almost always because there is a disconnect along the messaging pathway.
The hypothalamus isn't sending the memo to the pituitary
The pituitary gland gets the memo but doesn't listen
The pituitary isn't sending the memo to the adrenal glands
The adrenal glands get the memo but don't listen
The memo goes through but the adrenals can't make cortisol (not enough raw material, enzyme issues, etc.
The memo gets through and the adrenals make cortisol but the tissues don't listen.
The list goes on and on. There are many other ways in which the main message doesn't translate into 'make more cortisol', and there are countless reasons why this can happen. In fact, just to name one, there are over 40 genetic defects that have been identified that affect on or more of the above steps. That's not adrenal fatigue...that's genetics.
If you want a list of things that DO directly affect the adrenal glands' ability to make cortisol, here they are:
Removal of the adrenal glands
Trauma or damage to the adrenal glands
Infections which destroy the adrenal glands (i.e. tuberculosis)
Autoimmune damage to the adrenal glands
Addison's disease
Certain anesthesia drugs used during surgery which can directly affect adrenal function
There are others, but these 6 things account for the majority of cases of low cortisol coming from an actual adrenal gland problem.
If you really want to know what makes cortisol levels go down, and you really want to fix your own cortisol levels if they are wonky, you have to look for the underlying reasons why it's low.
There are literally HUNDREDS of reasons why cortisol levels go down...and if your doctor doesn't understand the complexity of these hormonal symptoms and what affects them, then you will continuously take medications and supplements for 'adrenal fatigue' that doesn't exist...and you will NEVER get better!
HERE IS A SHORT LIST OF SOME CAUSES OF LOW CORTISOL:
1. Prescription medications
2. Over exercising
3. Genetic defects in cortisol production and metabolism
4. Changes in the cortisol receptor on cells
5. Female hormone imbalances (especially low progesterone)
6. Thyroid hormone imbalances
7. Being overweight
8. Dietary influences (i.e. high fat, high sugar)
9. Improperly and/or excessively dosed bioidentical hormone replacement therapy
10. Sleep disorders
11. Impaired liver detoxification
12. Nutrient deficiencies
13. Excessive levels of catecholamines (adrenaline, noradrenaline)
14. Chronic infections (i.e. Lyme disease, etc.)
15. Heavy metals
16. Intestinal dysbiosis (leaky gut, bacterial imbalance, etc)
17. Endometriosis
18. Autoimmune diseases
19. Excessive doses of testosterone replacement
20. Excessive doses of DHEA replacement
and the list goes on and on....!
Bottom line....supplements are NOT the solution. They may temporarily improve symptoms and generally help the overall stress response...BUT, cortisol levels will never improve if your doctor doesn't figure out why they are low!