talk to me about adrenal fatigue
June 18, 2021 2:23 PM   Subscribe

Is it a thing? If not, what is wrong with me?

A friend of mine started taking a supplement to help with adrenal function because she was feeling horrible. She described her symptoms to me and said that based on her research she's experiencing adrenal fatigue.

My symptoms are identical to hers. I'm exhausted, I have trouble waking up in the morning, I have gained a lot of pandemic weight that's hard for me to lose, not least because I'm too exhausted to even drag myself out for a walk. I get a sudden burst of energy in the evening and am suddenly able to be prolific and bang out page after page of writing (I work freelance for an arts publication). I have trouble falling asleep at night.

So I asked my endocrinologist, and she said adrenal fatigue isn't a thing and whatever supplements my friend is taking is probably homeopathic woo-woo stuff.

I don't believe in homeopathy. But my endo checked my blood, and my thyroid is fine, my iron levels are normal, and I have a Vitamin D and B12 deficiency that is already being treated with vitamins for the past two years, so those are also showing normal now.

So what the fuck is going on? I start a new job on the 28th and we are in the process of moving and I am a walking zombie. I realize that literally everyone everywhere has just gone through the most stressful and frightening year in their lifetimes, and now that the vaccination rate is high enough in my area mask and social distancing mandates are being removed and the world is starting to feel more "normal" so maybe this is some sort of crash after a year of hypervigilence? But how do I treat this? I don't want to go into woo-woo land but I've been reading up on adrenal fatigue and how it's linked to cortisol and stress and I am starting to think that this is what is going on with me.

Help. I cannot function like this.

Full disclosure: I have bipolar 2 (in treatment for nearly 15 years, well-managed, this does not feel like a depressive phase), anxiety disorder (in treatment for 2 years, also well-managed, drowsiness and fatigue is like the opposite of what anxiety feels like for me), and C-PTSD (so I was hypervigilent way before COVID). I also have PCOS (hence the endocrinologist, in treatment for 20 years).

posted by nayantara to Health & Fitness (22 answers total) 5 users marked this as a favorite
Adrenal fatigue is not a thing.

In my non-medical opnion, I would say you are correct, this is a "crash" after a year plus of extra stress, plus moving stress and new job stress. I hope you feel better soon.
posted by blnkfrnk at 2:33 PM on June 18, 2021 [7 favorites]

I realize that literally everyone everywhere has just gone through the most stressful and frightening year in their lifetimes, and now that the vaccination rate is high enough in my area mask and social distancing mandates are being removed and the world is starting to feel more "normal" so maybe this is some sort of crash after a year of hypervigilence? But how do I treat this?

1. Yes

2. Rest and self care. For a lot longer than you think. Could you take some time off?
posted by medusa at 2:38 PM on June 18, 2021 [4 favorites]

Best answer: IANAD but I imagine there are going to be a lot of cases like this over the next little while as people emerge from pandemic conditions and expect themselves (or are expected) to have the exact same levels of energy, motivation and ability to cope as we did a year ago. I used to be able to walk everywhere I needed to with no problem, now I get winded and muscle cramps from just going 10 minutes down the road to get groceries.

But how do I treat this?

I would talk to your mental health doc and see what they recommend or if they have any thoughts.

Otherwise: try to keep going. Exercise a little more every day, even if it's just a 5 minute walk. Keep up with your meds. Eat and drink well, try to get as much sleep as you can. Resist the urge to rely on woo-woo treatments. Treat yourself with kindness.

I saw someone recommend most people might need to treat this post-pandemic time as rehab/recovery and not a return to "normal". Try to frame things like that in your mind. You're absolutely not alone.
posted by fight or flight at 2:54 PM on June 18, 2021 [10 favorites]

I also have PCOS (hence the endocrinologist, in treatment for 20 years).

Fatigue, an inability to lose weight, & trouble falling asleep can happen during perimenopause.
posted by Iris Gambol at 3:15 PM on June 18, 2021 [6 favorites]

I asked this question a while ago.

Adrenal fatigue, as far as i can tell, isn't a thing. In my search of what to do, i finally found a neurologist who focusses on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).
The diagnostic process is long but finally i feel heard and somewhat hopeful that my quality of life may improve again.
Where i live (German speaking Europe), ME/CFS is quite often considered a Woo sort of condition, because it is often "diagnosed" by alternative practitioners of all kinds or self-diagnosed.
It took me a while to figure out which type of medical specialist to see, and i don't know if where you live it would be a neurologist.
posted by 15L06 at 3:22 PM on June 18, 2021

Response by poster: I'm 36, so perimenopause seems unlikely. (I was diagnosed with PCOS in high school.) I am on a mini-vacation this week and next before my job so was hoping to somehow solve this problem, but maybe the solution is indeed rest and self care.

fight or flight's answer makes sense to me. The inability to excersize properly is one of the biggest things that's bumming me out - I used to be a runner before I hurt my knee (freak accident, not running related) and I used to swim (pandemic closed my gym and they never reopened so bye bye pool) and I had a competitive weightlifter buddy who used to help me with strength training (again, bye bye gym, so bye bye that) and now literally walking the dog to the park two blocks away and around the pond and back has me winded. And the muscle cramps! When I sneeze my ribs cramp! Sneezing makes me cramp! What the hell!

I'm not gonna take any supplements, don't worry. I guess R&R and gentle excersize and trying not to hold myself to former fitness standards is the way to go. I wish I had excersized more last year. What a waste of all that time off. Sigh.
posted by nayantara at 3:47 PM on June 18, 2021 [1 favorite]

Best answer: A few years ago an acquaintance mentioned that she was taking supplements to help with adrenal fatigue. "Maybe that's my problem!" I thought, but later when I put a little bit of time into researching it, discovered the same as you and medusa have: it's just not a legit diagnosis according to any medical professional I'm inclined to trust.

Anyway, it's only gotten worse for me since the pandemic. It's probably cold comfort to hear from someone else, but I feel exactly the same way as you do right now. I just cannot muster the energy to do a goddamn thing, professionally or otherwise. I have a lot of abstract advice, absolutely none of which I have the bandwidth to follow myself, even though I know it'd make me feel much better. (Get some exercise or go for a long walk everyday; try for a regular bedtime; try to give up your pandemic vices, esp. smoking weed or having more than one drink at night; read more novels; be generous with yourself when you fuck up; if you're having trouble doing the things you "ought to" get done, procrastinate by doing other useful things, physical things, like tidying the house or anything else that you can zone out on. Practically, I've found that dictating text on my phone while I'm on a long walk is a useful workaround for writing things I can't bear to bother getting started on.)

But beyond just you or me, if you're in the US, we've just had four years under Trump; half the country has been glued to the news cycle, constantly waiting for the next terrible thing. For so many people, it's been trauma after trauma, and even if those traumas haven't affected you directly, it's jarring to see the systems of oppression our country runs on laid bare, and then even more jarring to realize that people around you are so invested in refusing to see it themselves. Then the pandemic hit, which has upended everyone's lives in related and unrelated awful ways, even if they were spared the worst of it. Plus whatever personal turmoil you might've encountered over the past few years, piled atop it all. Meanwhile, very few of us have had a chance to recover; just taking a break by checking out (avoiding the news, etc) is hardly healing when you know your spirits are salved only through not-knowing. Which is to say that this is pretty understandable, honestly, and you're not alone, and I have absolutely no transformative advice for you besides throw your devices in a river and quit your job and spend five hours a day walking? Honestly I think that sounds like a great job, if only someone would pay me to go on long walks. Anyone? Anyone?
posted by knucklebones at 3:55 PM on June 18, 2021 [37 favorites]

Perimenopause isn't unheard-of in one's mid-30s. The joker in the pack is that it's undiagnosable except by looking at the complex of symptoms and being like "yep. perimenopause." If you eliminate most other possibilities... Heather Corinna has a new book out What Fresh Hell Is This? that might be a worthwhile library checkout for you.
posted by humbug at 3:57 PM on June 18, 2021 [2 favorites]

I think it's understandable to be feeling tired, but winded-ness you're describing doesn't sound to me like something you should just grin and bear.
This article provides a breakdown of how a symptom of fatigue feels in relation to a bunch of different illnesses that cause it.
The advice to take it easy and do self-care is great. But I would also say get a symptom tracker app on your phone and really track it, and try to find the root cause of this.
posted by bleep at 3:58 PM on June 18, 2021 [3 favorites]

Best answer: Coming back to this briefly to add: it may be useful to you to not try to focus too much on it being one thing right now. Give yourself a few weeks of doing a little bit more each day if you can and see where you're at. If it helps, it helps, so keep doing it. If it doesn't help, if the fatigue and so on are still bad, definitely see a health professional and investigate underlying medical causes (quite a few of my friends have been diagnosed with CFS recently, I think it's slowly becoming more recognised).

Personally I think for me, and maybe for you, it's a combination of a bunch of different things. For a while I was obsessed with trying to find one single diagnosis that covered everything because then it'd be a treatable problem! I could fix it! I love fixing things!

But thinking about it now, a year and change out, and I think actually it's a combination of a lot of stuff: lack of exercise + stress + less balanced diet + less social/mental stimulus + poor sleep + probably a bit of anxiety/depression + did I mention stress? All of these things take a toll on the body as well as the mind, hence the rehab mindset.

What's helping me so far is trying to reward myself for the small things. I did 20 minutes of not even very intense yoga the other day and actually felt okay afterwards, so I counted that as a win for the day, even though compared to the Before Times it's basically nothing. Take things from where you're standing right now, not from where you were before. It helps.
posted by fight or flight at 4:07 PM on June 18, 2021 [6 favorites]

IANAD / I am not your doctor, but when you say your thyroid is fine, what do you mean by "fine"? Because there is a fair amount of controversy about where hypothyroidism starts, whether subclinical hypothyroidism should be treated, and then other corollaries around supplementing T3 / T4. The reason I mention it is: many women feel optimal when their TSH level is around 1, while I believe the current interval of "normal levels" goes up to 5.

In terms of personal experience, I felt all the symptoms you described for several years, right down to energy bursts in the evening (in my case preceded by a mid-afternoon slump) when my TSH was around 5. My PCP said it did not need to be addressed, but an endocrinologist I saw lowered my TSH by putting me on a combo of T3 and T4, and all of my symptoms resolved. Several women in my friends group have had that same experience -- we are all in our late thirties/early forties.
posted by virve at 4:37 PM on June 18, 2021 [12 favorites]

Best answer: I don't know what allergens are like where you live but here in Northern VA the pollen or something is out of control and we are all miserable. Allergies make me sleep poorly so even when I think I've gotten a full night's sleep I'm actually kind of wonky and useless the next day.
posted by selfmedicating at 4:59 PM on June 18, 2021 [1 favorite]

My answer is the same as it was in that thread. I don’t believe in adrenal fatigue per se but I did hit a weird wall and lifestyle changes did help, especially exercise and one day a week sleeping in. I’m anticipating a post pandemic crash at some point too.
posted by warriorqueen at 5:16 PM on June 18, 2021

Best answer: I was so tired today that I closed my eyes for a while on the elliptical machine at the gym. Supposedly everything about me is fine and healthy but
1. late 30s/early 40s are a real adventure in just feeling like shit all the time for basically no reason at all.
2. everything about everything now is exhausting beyond measure.

I was already pretty tired and whatnot before the panini times but yeah, I don't really think it's odd or pathological (as in, a diagnosed pathology) to be tired as shit all the time after living in a state of emergency for anywhere from 15 months to 4.5 years.
posted by We put our faith in Blast Hardcheese at 6:18 PM on June 18, 2021 [4 favorites]

I agree that it could be a post pandemic crash. That's a valid thing to be going through!

My suggestion is to build a sense of safety and well-being in any arena you can. We've all been through a trauma and it's ongoing in many ways.
In that realm breathwork has been a great stabilizer for me. I use the Stasis program and an app with breathing exercises. This is based on validated research that serves as the basis for data on smartwatches like Garmin.

More ideas: Eating well, removing stress, enjoying loved ones, reconsidering sugar and caffeine, dialing down the news cycle, raising your heart rate through exercise, mourning, practicing mindfulness or a spiritual practice, traveling to a different place, hugging a friend or animal, crying, nature. Check out the work of Emily Nagoski on the stress cycle — have you "completed" your own personal stress cycles?

Regarding the me/CFS mention above, and bringing a US lens, it is recognized by the CDC as a legitimate condition. You can read about the symptoms there. Unless you've left out several things, I don't read me/CFS in your question. But I will add that long covid includes exhaustion and can follow on even after a mild case. The suggestions for treatment include resting, pacing your energy, not pushing beyond your limits. I think you're unlikely to have it but want to mention as it's a relatively new cause of fatigue. The CDC has guidance for that too.
posted by rockyraccoon at 7:15 PM on June 18, 2021

Best answer: Potassium can be a good non-woo supplement for muscle cramps.
posted by Nancy Lebovitz at 7:19 PM on June 18, 2021 [2 favorites]

Potassium can be a good non-woo supplement for muscle cramps.

Yes. If I had your tiredness and cramps and other symptoms (and I have had in the past), I would increase my potassium, magnesium and Vit D intake (regardless of blood test results, with the support of my GP). Potassium helps a whole range of bodily functions because it is an electrolyte as well as a mineral. Dried apricots are a great source, as are leafy greens, bananas and other some other fruits, potatoes, lentils, etc.

I've not seen potassium supplements on the shelves, possibly because an overdose of potassium via supplement could cause major health issues (interfering with electrical impulses to the heart for example), but when I get tendon cramps in night I lick up a 1/4 tsp of 'Lite Salt' which contains a mix of potassium chloride and sodium chloride, followed by a glass of water. The cramps begin to fade within moments and I can usually get back to sleep.
posted by Thella at 7:46 PM on June 18, 2021

Is there any chance that you'd changed ventilation practices at about the time you started waking up groggy in the morning? Say, closing doors and windows? We'd started closing our bedroom up and running a HEPA filter to deal with allergies, but a CO2 meter showed that CO2 levels were building up to levels that interfered with sleep. Cracking the door and a bathroom window was enough to get some outside air mix in. The effect on sleep quality was immediate.
posted by dws at 7:50 PM on June 18, 2021

Best answer: I've also been experiencing a crash quite similar to yours. I have been finding ways to recharge - staring at trees is good. Naps. A random hard cry.

All that said, have you had a sleep study done? Sleep apnea is exhausting, even if you think you're sleeping, and can cause weight gain.

But, yeah, the pandemic, politics, an attack on the Capitol, a brutal allergy season, protests and murder and racial attacks, and **just generally waving at everything** PLUS a new job AND moving? I don't know if you need to look much harder for reasons to feel utterly shite.
posted by Ink-stained wretch at 9:02 PM on June 18, 2021

Best answer: Make sure you're taking enough Vit. D, even with what you're taking, and spend 10 minutes in the sun every day if you can. I get horribly draggy if my B12 is low, and I resolve that with red meat a couple times a week, supplements exist, as well. No harm in boosting B12 for a week or 2 and seeing if it helps. Lots of other things can cause lethargy; did your doc order a liver panel? Probably not an issue, but it's easy to check. Have you ever been tested for lead? it's still around in buildings, worth testing. Check your home for allergens and make sure the carbon monoxide detector is working.

Make sure you're getting plenty of veg, fruit, fiber, etc. See if you can get on a better schedule, and try hard to get outside every day, ideally walk a little; friends who will walk with you are a plus.

You're working, moving, starting a new job, and we've just had several national/ global crises. It's a lot to cope with, and having a reaction as things are improving is typical; you don't fall apart in the crisis, you wait till it's not as big a crisis.
posted by theora55 at 9:09 PM on June 18, 2021

I am 38, have PCOS and Theralogix Inositol supplement has been a game changer for me. The 40:1 ratio has been studied, peer reviewed, published, etc.

Feel free to MeMail me if you have any questions.
posted by nathaole at 10:21 PM on June 18, 2021

I went through a phase last year where I was so mentally and emotionally fatigued that could barely get out of bed. My psychiatrist prescribed me a small daily dose of Vyvanse. It worked wonders to get me up and moving, exercising, and engaging in my hobbies again.
posted by ananci at 9:49 AM on June 19, 2021 [1 favorite]

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