Evolving The Theory of Adrenal Fatigue

Written by: Mike Ritter

In my generation, most young boys and girls have experienced an awakening upon our arrival to adulthood. Most of us did not become firefighters, actors, comedians, or world explorers, but instead dove directly into the professional world, crossing our fingers, and praying we listened to the right people. At twenty-four years old, the reality of ‘Adult’ing’ was unveiled to me as 9-10 hours of seated task work, constant problem solving, multi-tasking, 1 hour of exercise (big maybe), followed by endless multi-tasking. Factor in 50 (or more) TV/radio/web advertisements, synthetic food occupying my imagination, and an ample dose of blue light, it’s easy to see that being an adult is more about survival than enjoyment.

Many people reach for the nearest gym as a solution. Some watch the news to find the best diet, but those solutions are all but guaranteed misses if we continue this trend of massive stress overload.

Vast amounts of research compiled over the last two centuries have provided us with reason to believe that a lifestyle filled with chronic stress is at least partially responsible for many modern chronic diseases and dysfunctions. Men are reporting low testosterone at younger and younger ages, while the average age for menopause is slowly getting lower.

Initially this was attributed to a factor called ‘Adrenal Fatigue.’

Adrenal Fatigue: exposure to chronic stress causing the adrenals to go through stages of excessively high cortisol output and then fading to low levels of cortisol output, usually resulting in a low production of sex hormones

This phenomenon of metabolic dysfunction is believed to be responsible for many of the health problems we deal with in today’s world. I have actually used the term ‘adrenal fatigue’ in the past since it simply resonated well with people and is pretty ear friendly. It had the word ‘adrenal’ which accurately targeted an anatomical point of interest and ‘fatigue’ which accurately described a symptom which a person feels after years of chronic stress. There is a major flaw in this term however. Using this term with patients, clients, or peers ineffectively communicates the vastly complicated nature and individuality of each case.

The Problem with ‘Adrenal Fatigue’


Traditionally, if you had your serum cortisol or free cortisol tested, and it was below reference range, you would told you have some degree of Adrenal Fatigue. This misappropriation oversimplifies the problem.

Example: The fitness world attempted to fix back problems by stretching hip flexors would fix chronic sitting. The assumption was that sitting created ‘shortened’ hip flexors, preventing full hip extension when standing and forces the lower back to hyper extend to compensate. This wasn’t completely wrong, as chronic sitting does typically result in poor standing/walking mechanics, but it’s not because the hip flexors became short.

You may be thinking; what’s the difference? The end result is the same.’ But it’s not.

That misappropriation led to ineffective strategies. The presumption that muscles eventually become ‘shortened’ resulted in many (sometimes under a fitness coaches watch) wrenching themselves into hip extending stretches to ‘lengthen’ the shortened muscle and banking on a positive result. In reality, tight muscles are not ‘shortened at all.’ They are a result of a mechanistic problem created when the nervous system memorizes positioning, breathing patterns, bone and muscle density requirements for the bulk of your life’s work – sitting. In essence, your body begins to ‘prefer’ or ‘adapt’ to the seated position. It’s a much broader picture and simply letting your 250lb man-child of a trainer wrench you into a stretch will rarely result in better active range of motion.

Ultimately the best way to fix the problems caused by chronic sitting, is to avoid chronic sitting, practice better breathing patterns, and move around with more frequency and variance. How does this apply to adrenal fatigue?



The same principles apply. The fatigue and symptoms associated with adrenal fatigue are actually a result of your adaption into undesirable state of overall metabolic function – not the fatiguing of one, albeit important, gland. This could be caused by a wide variety of factors, some are lifestyle related and some not. Associating this multitude of inputs with the term “adrenal fatigue” inevitably gives the impression that the solution lies in improving the function of the adrenals. This reductive approach is rarely an effective solution for chronic problems. Many factors such as alcohol use, infections, blood sugar imbalance, chronic inflammation, and emotional stress influence not only the adrenals but your detox capacity, muscle tissue quality, digestive tract, and more. Dysfunction in those systems cyclically affects each other as well.


Other factors that affect HPA Axis Dysfunction



COMT is a gene which helps to break down neurotransmitters epinepherine, norepinephrine, and dopamine which are, in large part, responsible for igniting your almighty fight or flight stress response. When a stressful scenario has concluded, COMT comes right along and starts sweeping the floor of these sympathetic NT’s, making room for a much needed rest and relaxation. For some, that doesn’t come easily. Some researchers believe that up to 80% of people have some level of mutation in this gene, suggesting that most people do not effortlessly recover from stress. Research on COMT is providing a window as to why some people are crushed by the discomforts of crowded rooms and others seem to never ever burn out regardless of the circumstances. Some people, genetically are more prepared to recover from stressful situations than others.


Hydrochloric Acid is responsible for breaking down proteins, kills unwanted bacteria, and helps to produce pepsin which also assists in breaking down proteins. Stress naturally decreases the amount of HCL produced in the gut, since stopping for chow won’t be necessary during a boxing match or if and when you need to escape a dangerous situation.  Chronically low levels of HCL ultimately means that foods you consume do not get broken down in the gut effectively and can lead to nutrient deficiency or other consequences of malnutrition.


With High-Intensity-Training still raging as the most popular training method, more people are busting their butts in the gym with fury. Some community based training facilities encourage training 6 days a week of high intensity interval based weightlifting. Without ample time dedicated to flushing the chemical stress response from training and recover from the catabolic nature of training, exercise can tear down a body faster than it can rebuild. Although movement and intense activity is a tremendous help to optimizing HPA Axis function, high levels of intensity in training must be coupled with active recovery methods both mentally (alpha states) and physically (joint mobility, massage, float tank). Overdriving exercise alone can cause stress maladaptation in individuals who do not recover well from stress or do not take the time to address joint inflammation incurred through weightlifting.

Finding a better description

HPA Axis Dysfunction: this term is a little more descriptive as it describes a maladaptation of the entire Hypothalamus-Pituitary-Adrenal Axis. From the brain down to the adrenals there are a plethora of ways an individual can over or under produce hormones inside of this chain, resulting in poor output of the adrenals. This system however will find the most efficient way to respond to the inputs you give it.

Stress Maladaptation: Your body has simply adapted to the stressors. Remove or manage those stressors and your body will adapt accordingly. Finding hidden stressors is not a simple task, but this term more accurately describes the situation. This is also more ear friendly for clients and patients. It directly states that they are experiencing an adaption to negative inputs and not the fatiguing of a gland.

Another thing that should be noted are the factors that impact overall adrenal output and the creation of sex hormones:


There is still plenty of evidence that regularly committing to 7-9 hrs of sleep, a diet absent of processed oils/artificial sweeteners/processed sugars & starch, intelligent movement practice, and a variety of mentally stimulating tasks can improve the entire HPA Axis. Our bodies are great compensators, and metabolic functions are very expensive. Wherever we can afford to slow functions down to preserve energy or allocate it somewhere else.

Rather than communicating that some gland gets sleepy because of a high workload, think of it as your body just borrowing currency and allocating it elsewhere. Eventually over time, your HPA Axis will essentially learn, or prefer functions which meet the demands of your life which may not be in-line with optimal function or health. Acute (sometimes underlying) infections can also affect your HPA Axis function.

Some people can adapt well, others not. But the good news is, if you’re alive, you’re still adaptive.


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