Adrenal Exhaustion:  The Rest of the Story


The term ‘adrenal exhaustion’ has gained international notoriety over the past two decades as the masses desperately search for reasons why they are exhausted, sensitive to stress, and in chronic pain.  Proponents of the ‘adrenal exhaustion’ theory portend that the adrenal glands lose their ability to produce stress hormones, mainly cortisol, under the stronghold of chronic stress.  The end result is complete ‘exhaustion’ of the adrenals and a drastic reduction in levels of the body’s main stress hormone, cortisol.  An avid proponent of the term ‘adrenal exhaustion’ claims:



“The medical profession is far behind when it comes to understanding adrenal gland problems.  In 2011, they still do not recognize adrenal insufficiency, adrenal exhaustion or adrenal burnout as real health conditions.  This is very sad, as the situation is so common.”


Thanks to the advances in modern medicine over the past century, the true causes behind stress induced low cortisol states are far more sophisticated and complex than this terminology implies. For, the adrenal glands are just one of many organs and structures involved in the stress response system. And as members of a system, they cannot and do not act independently.  Other extremely influential factors are command centers in the brain, other hormones, the immune system, genetics, toxic exposures, nutrient deficiencies, and a person’s individuality (personality type, early life experiences, perception of stress, etc.).


Forgive the simplicity, however when I lecture on this topic, I often use the example of a stress response ‘family’ in trying to describe the components of the stress response system (medically termed the ‘hypothalamic-pituitary-adrenal (HPA) axis).  The hypothalamus is the central command area and is responsible for making two very potent hormones (CRH & AVP) which then direct the pituitary gland to produce another hormone (ACTH) that ultimately tells that adrenals to produce cortisol.  The hypothalamus could theoretically be viewed as the mother (since, if ‘mama’s not happy, no one’s happy!), the pituitary gland (second in command) could be viewed as the father, and the adrenal glands, and all other end organs for that matter, would represent the children.  Now, envision these family members all living within an enclosed, stressful environment (your body) for an extended period of time.  There are several extremely important factors that will determine how well these family members get along and whether or not the children will become productive members of the clan to keep your environment healthy and functional.


Communication is perhaps the most important element in maintaining family harmony.  Where can the disconnection occur?  1) If the parents do not communicate with each other (hypothalamus messages are not relayed properly or heard correctly by the pituitary gland); 2) If the parents mis-communicate; 3) If the parents give an order to the children and the order is either not received or ignored (adrenals do not receive or do not respond to the higher commands); 4) If the messages being relayed at any level are muffled by a closed door or misinterpreted because of outside factors; 5) If the children (adrenals) receive the memo and produce cortisol appropriately, but the environment (your body) is unaffected (a condition known as cortisol resistance).


Now consider all of the potential factors that can contribute to communication pathways within the family unit…the possibilities are endless. The mother (hypothalamus), the father (pituitary), and/or the children (adrenals) may be unhappy, unhealthy, damaged, or traumatized.  Perhaps one or more family members are overworked, under nourished, less productive, unable to give proper direction, mentally challenged, verbally sparse, or even exhausted.  Also consider that the adrenal children need an adequate amount of cholesterol, progesterone (a reproductive hormone), B- vitamins, and vitamin C in order to carry out any orders received from their central parents.


Now imagine your stress response family (HPA axis) has invited all of your the relatives over for the Holidays…aunts (neurotransmitters), uncles (amino acids), cousins (components of the immune system), grandchildren (enzymes), and grandparents (adrenaline, noradrenaline).  How will this affect your family communication pathways and the functionality of your environment now?  Factor in now the environment of you homestead…what is the weather report?  Have you paid your utility bills?  When was the last time you went to the grocery store?  Does your vehicle contain enough gas to transport the members of the family where they need to go?


Although my description is brief and perhaps a bit juvenile, do you still consider the adrenal children in this scenario to be the center of the stress response family universe?  I venture to guess the answer would be ‘no’!  To promote the adrenal glands as being independently functioning, central components of the stress response system is not only inaccurate but also diminishes the true complexity of our stress response systems.


Only through a better understanding and appreciation of all the members of your stress response family, how they communicate, and what factors affect them will your internal environment fully thrive.  In good health….