Scott: Can you talk about adrenal fatigue, and explain what that is?
Dr. Lena D. Edwards: Well, the concept of adrenal fatigue basically implies that the amount of stress hormone production goes down over time, particularly cortisol, because of the adrenal's inability to keep up with the demand of chronic, ongoing stress response system activation, basically. The concept is that the adrenal glands sort of just independently decide that they can't do what they need to do anymore, and they burn out, resulting in low cortisol, which primarily manifests in patients as fatigue. Hence the term "adrenal fatigue."
Scott: You talk about cortisol. What is that? And why is it important? And why is it something that we need to know about?
Dr. Lena D. Edwards: Cortisol is one of our body's main catabolic hormones, meaning wear and tear hormones. It is responsible for really the regulation of many of the other hormones and bodily systems. In order for those systems to function properly, you have to have cortisol. Cortisol's not the evil, bad hormone. It has to be here, it has to be produced and released in what's called a circadian pattern.
It goes up in the morning and allows us to get up, and controls blood sugar, blood pressure throughout the day, controls blood sugar control, preventing fluctuations. As the day goes on, cortisol levels go down, and then cortisol's supposed to be at night while we're sleeping, so the hormones of growth and repair like cortisol and melatonin can go up, so we repair our tissues while we're sleeping. That's essentially normal cortisol release pattern.
Scott: And what's abnormal, then? What are a lot of people suffering from, and what does it do?
Dr. Lena D. Edwards: Right. Anything but that. Abnormal cortisol release patterns can show up in a variety of different ways. Sometimes people are making too much all the time. Sometimes they don't make enough during the day and they're making it at night, and that's why they can't sleep. Sometimes they have in general just low cortisol production over a 24-hour period.
There are different reasons for why that happens, the majority of which have nothing to do with the adrenal gland deciding that it's not going to make cortisol anymore. There's a very complicated system that's set up, primarily with two structures in the brain. One is called the hypothalamus, and the other one is called the pituitary gland. Those two glands make hormones which in and of themselves do a lot of things independent of their relation to cortisol. But those hormones tell the adrenal glands to make cortisol.
Most of the research shows that states of low cortisol actually arise because of a miscommunication, or a lack of communication, between those central nervous system structures and the adrenal glands. The memo might be there, but the adrenal may not get it, and there's a lot of other things that can happen, which ultimately culminate in low cortisol. But there's a lot of different reasons why that can happen.