Being so, so tired

Chronic & curable

If you are feeling tired all the time, are too dependent on coffee, or are susceptible to colds, you may be suffering from a very curable but controversial 21st century syndrome. Anna Magee finds out more

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Four years ago, if you’d met me you would have found little out of the ordinary: a woman rushing around town, exercising, socialising and working on multiple projects, including a full-time job, home renovations and part-time study. But if you’d looked closer you would have seen dry, sagging skin, dark circles under my eyes and a bloated tummy. If we’d chatted, I would have said, “I am so, so tired,” and complained of not being able to get any decent sleep. If we’d eaten together, I would have picked the ‘diet-iest’ thing on the menu and then doused it in salt, before chasing it with caffeine. And if you’d come over on a Sunday, you’d have found me sleeping – whatever the time.

Not normal

When I complained to my doctor of tiredness and occasional panic attacks, she told me it was “normal given your workload” before advising me to take a day off and prescribing some anti-anxiety medication. Certainly, everyone I knew complained of being tired, so I assumed what I felt was normal. It was by accident that I realised that it wasn’t.

While co-writing a book with Charlotte Watts, a nutritionist, I came across a reference book written in 2002 by the naturopath Dr James L Wilson. It was called Adrenal Fatigue: The 21st Century Stress Syndrome and described a condition that James had observed after years of working with stressed-out patients in the 1980s and 1990s. The list of symptoms described me both physically and emotionally: difficulty getting up in the morning, frequent colds and infections (especially sore throats), severe salt cravings, low blood pressure and feeling dizzy when standing up, less enjoyment in life, decreased sex drive, increased PMS, less accurate memory, a shorter fuse, and a need to use chocolate and coffee just to keep going.

The theory states that these symptoms occur when our adrenal glands – two walnut-sized glands that sit just above the kidneys – get overworked. The adrenal glands are responsible for churning out cortisol, the hormone that helps us cope with short-term stress. But because our modern lifestyles are relentlessly stressful, James contends that the adrenal glands tire out, causing cortisol levels to plummet and leaving us no longer able to respond effectively to stressful situations. And because cortisol has an impact on everything from blood pressure to digestion to the ability to get out of bed in the morning and fall asleep at night, the symptoms resulting from low levels can appear random and unrelated.

Conflicting views

Although the World Health Organization recognised adrenal fatigue as a disorder in 2010, many in the medical community remain sceptical. Medically speaking, you can have extremely low adrenal function, known as Addison’s disease, or you might have Cushing’s disease, in which your body makes too much cortisol. But for most doctors, there’s nothing in between – your adrenal glands either work or they don’t. “There’s no such condition as adrenal fatigue or exhaustion,” Ashley Grossman, a professor of endocrinology at the University of Oxford, says. “Tiredness, low blood pressure, sleepiness, salt cravings and irritability are all non-specific symptoms that a lot of us have a lot of the time. But for every one patient I see with adrenal failure, I see a thousand who are simply feeling a little under the weather.” He explains that an endocrinologist would typically investigate adrenal function using a blood test called the synacthen test, which measures your body’s ability to make cortisol. “Most people who complain of adrenal fatigue can still make cortisol – there’s nothing wrong with them,” he says.

Marilyn Glenville, natural health expert and author, states that doctors are always looking for extremes,“but as natural health practitioners we recognise that when it comes to adrenal function there are shades of grey.” Elaborating, she says, “There are different stages involved in this: adrenal fatigue, depletion and, at its worst, complete adrenal exhaustion and collapse. What we’re trying to do is catch the early signs and treat them before it gets worse.”

Though I usually favour the opinion of the medical community, I couldn’t argue with my symptoms, or the fact that 12 weeks after Charlotte gave me a strict programme to replenish my adrenal glands, I began to feel better than I had in years. I had to stop eating fruit in the morning and have a protein-based diet, and also had to take breaks every 90 mintues to fit in with the body’s “circadian rhythms” and told me to add sea salt to my food. What? “Your adrenal glands are responsible for producing a hormone called aldosterone, which tells the kidneys to retain the salt your body needs to function,” says Charlotte.  “When your adrenal glands are depleted, they don’t produce enough aldosterone, so your kidneys eliminate more salt through the urine, leading your body to crave it.” I had to go to sleep when I was sleepy and more importantly, I had to dedicate 10 minutes to meditation daily. “This is about making space in our days to recover from stress, rather than waiting for that elusive two-week break in August each year,” she elaborates.

Booming industry

Today, an entire burnout industry has arisen. There is an array of spas, retreats and even rehab centres offering specialist services to help solve your burnout, breakdown or adrenal fatigue. At the KamalayaKohSamui spa in Thailand, you can book in for a week-long “burnout programme” designed for people who have “lost the energy to deal with their daily routines after being under prolonged stress”.  

When I describe my own experience to him, Ashley from the University of Oxford agrees that my kind of chronic tiredness – he won’t call it adrenal fatigue – can respond well to the lifestyle changes I made. “When I find nothing medically wrong with patients, I tell them changing their lifestyle is more preferable to taking specific supplements or drugs,” he says. “Look at your lifestyle, the way you deal with stress and how much sleep you get, and you will build the tools to help yourself for the long-term.” And on that, everyone agrees.

The Telegraph