Stress, Fatigue and Autoimmune
Mar 11, 2023
Fatigue is the #1 complaint with patients with autoimmune, yet we aren’t given any solutions other than to rest more or perhaps take more supplements.
If that worked, fatigue wouldn’t be an issue, now would it?
This article will explain a few major influences for fatigue, including:
- The role of adrenals and why they are important for autoimmune
- Symptoms of a chronic stress response
- Natural strategies to improve fatigue and energy with autoimmune
What are adrenals and what's the connection with autoimmune fatigue?
Adrenals are glands that sit on the top of your kidneys. They produce hormones that help regulate metabolism, immune function, blood pressure AND your stress response. In this article we are talking about stress.
Now, "stress" is not a bad thing ... it's designed to protect us ... and with autoimmune we have a lot of "protecting" happening at the tissue level and in our life loads.
A stress response inside the body begins with a registered threat either inside the body (issues in tissues like inflammation in joints, muscles, digestive tract or a physical injury) OR external threats (perceived threats … stranger danger, work, family, finances, life load).
The body doesn't distinguish between the two ... both physiological and psychological stressors ignite the same chemical response inside the body, called the HPA Axis (Hypothalamic-Pituitary-Adrenal Axis). It is a complex cascade of hormones and neurotransmitters that manipulate metabolic reactions in the body.
Adrenaline and cortisol are involved in this process.
They are the stress hormones that produce the “adrenaline rush” – that feeling we get during a high intensity workout, an exciting hockey game or watching a scary movie. We are totally alert and living in the moment. That feeling is known as your body's "fight or flight" response. The release of hormones in the fight or flight response is your body's normal reaction to stress.
This type of stress can be positive, like when it helps you swerve and avoid a car crash or you navigate the chaos of Costco. After a short time of recovery, the flight or flight response dissipates and the systems in the body normalize.
We run into problems when we are always reacting to internal and external stressors. All day. Every day.
Food sensitivities, chemicals in our food supply, cleaning supplies, the environment. Tissue damage from autoimmune or other medical conditions. Side effects of medication. Life in the modern world with computers, email, traffic, work, personalities. Not enough time to restore.
The adrenaline hit no longer feels like a "rush" and we end up feeling physically and emotionally exhausted.
When adrenal glands are working, they also get fatigued and that can have a cascading effect on mood, motivation, sex life, social life, work performance and weight. When cortisol & stress hormones are constantly triggered, other systems in the body feel the impact:
- Our already hyper immune response is turned up (cortisol activates our immune system to deal with the threat at hand contributing to the physical symptoms you already experience with your condition)
- Sex hormones are suppressed and we have amplified symptoms of PMS, infertility, early menopause, skin, hair and nails
- Thyroid function is suppressed, impacting our ability to lose or gain weight, regulate temperature control
- Blood sugar raises, leading to medical conditions like insulin resistance or type 2 diabetes
- Digestive function is suppressed (stomach acid and digestive enzymes contributing to gas, bloating, bowel movement irregularities) and beneficial bacteria are suppressed, putting us at risk for leaky gut, IBS and other uncomfortable experiences
Suddenly we’re dealing with much more than just “stress”.
Symptoms of living in a chronic stress response
When your adrenal glands start getting tired/depleted, you start developing symptoms. There is no definitive group of symptoms as we are all unique in our biochemistry, but here is a list to consider:
- Fatigue (constant)
- Feeling of "overwhelm"
- Difficulty sleeping (ruminating thoughts that prevent shut eye, mid-night waking)
- Hair loss
- Mood swings
- Sudden weight loss (initially)
- Long term weight gain, especially around hips and thighs
- Joint pain
- Sugar & salt cravings
- Frequent urination
- Frequent infections like colds and flu
Unfortunately, there aren't any medically accepted blood tests for adrenal fatigue. Adrenal fatigue is not recognized by most medical professionals UNTIL our adrenals are so fatigued they almost stop working. At that point, the official diagnosis of "Adrenal Insufficiency" or "Addison's Disease" may apply.
If you feel you have the above symptoms, you should still see your doctor to rule out other conditions. They may even be open to discussing adrenal fatigue, or at the very least, wellness strategies that can help to reduce your physical or life load stress.
I strongly encourage the next steps to help improve your stress response. Chronic stress is a key contributor to chronic inflammation and disease. And ALL doctors agree on this point.
Thankfully, there are many actions we can take to reduce stress and improve both physical and emotional resilience and energy.
How to improve your stress response with autoimmune?
We start at the very beginning … prioritizing changes to diet, micronutrients and lifestyle in a way that makes sense for your diagnosis and your life circumstances.
Working on one aspect alone won't resolve the issue. I'm speaking from experience, having suffered infertility due to adrenal fatigue while working in a high energy corporate environment before I became a certified nutritional practitioner.
There are some lab tests you can take (saliva and urine) that will help you determine stress hormone levels, but they can be expensive. There is also no reason to wait on fixing your fatigue with tried and true support.
Proven nutrition to help improve fatigue
This is where I start each and every one of my clients inside The Integrative Autoimmune Network and private support. When you work on improving your stress response and fatigue, you improve not only your focus for all that you need to do, but you turn down the dial on your immune response AND improve digestion … two key motivating factors that will help you address inflammation for the long term so you can work to get your physical symptoms under control.
When we are in a constant state of “reaction” to threats (issues in tissues or life load), the body chews through more nutrients (especially antioxidants) and these need to be replenished. You’re eating not only for your basic metabolic needs, but to replace the nutrients the body needs to repair and recover.
Balancing blood sugar fluctuations and reducing food sensitivities and processed foods (especially refined flours … even gluten free flours) is an absolutely necessary first step. Lean protein, healthy fats and the right type of carbohydrates (plant foods) at each meal are also key to recovery and rebuilding energy. Caffeine is a no-no as it stimulates the adrenals and a stress response. And lastly, high mineral bone broths, micronutrients like calcium, magnesium, b-vitamins and vitamin C are also helpful, as well as some herbal teas, tinctures and select supplements.
When I help my clients & Network members use food as a healing component in overcoming physical and emotional exhaustion, they see substantial shifts and can experience a 50-70% increase in energy in only 8 weeks after getting on the right plan not only for their autoimmune, but their stress.
This means knowing the right types of food to eat and at what times. Having an easy meal plan in place reduces overwhelm ... Food is fundamental to recovery, and we shouldn't have to stress about it.
Proven lifestyle habits to help improve fatigue
I'm not going to tell you to sleep more ... you already know that. So let's talk movement, something that may be different to what you're already doing.
Rethinking exercise & movement programs is also critical to recovery. Lack of movement OR intense exercise undermine the stress response, metabolism and gut health. A gentle approach is best as it stimulates the lymphatic system (a key part of your immune response), cardiovascular health, digestion, and works with your nervous system without overtaxing the body, helping to avoid an unnecessary stress and immune response.
Where I see clients have the most benefit:
- Breath-based practices like mindful yoga (vs ashtanga), Tai Chi or Qi Quong which works to calm our stress response while building strength, mobility and range of motion for sore joints and muscles
- Light weight routines that are focused more on form (vs high repetitions)
- Moderate to low intensity cardio (walking, gentle cycling, swimming)
And finally, stress reduction is key.
Breathwork is the one action we have control over that can influence our autonomic nervous system which governs our involuntary physiologic processes (including heart rate, blood pressure, respiration, digestion) within several minutes. It also improve vagal tone, which helps produce neurotransmitters that help suppress pro-inflammatory cytokines, and research shows it can help with rheumatoid arthritis, IBD, depression and PTSD.
It is so powerful that I include it in The Integrative Autoimmune Network along with restorative, mindful yoga sequences because many of our clients want to be more active and build strength while recognizing the role that stress has on their physical symptoms. They are looking for practical, proven tools that they can integrate into their busy work/life schedules that will help them better metabolize stress hormones, and help calm their racing minds at night.
Some of my other other favourites we provide to clients and recommend as being supportive:
- Meditation (even 5 to 10 minutes a day can reap major benefits)
- At home movement & breath programs or apps
- Walking in nature (city parks included)
- Walking after meals (to promote digestion and blood sugar balance)
- Going to bed before 10pm
- Magnesium baths
Conclusion
Your adrenal glands produce hormones in response to both internal and external stressors (issues in tissues and life load).
Adrenal fatigue is a controversial disease that doesn’t have a medically approved diagnostic test, nor specific tell-tale symptoms.
With symptoms of adrenal fatigue, it’s important to see a medical doctor to rule out other potential conditions.
Nutrition is a must-do when suffering from fatigue to help balance blood sugar while also including some specific, adrenal and immune supportive foods. Food and micronutrients are fundamental to progress.
Breathwork, meditation, yoga, restorative exercise are all proven to help restore fatigue and build both mental and physical strength with autoimmune.
If addressing your fatigue and restoring energy is an important goal for you, we encourage you to reach out to learn more about The Integrative Autoimmune Network or private client services.
Recipe (Stress-reducing bath salt): Lavender Bath Salts
While this certainly won’t solve fatigue, it is a nice way to put the body into a more relaxing state.
Per bath
1 - 2 cups epsom salts
5 - 10 drops lavender essential oil
As you're running your warm bath water, add ingredients to the tub. Mix until dissolved.
Enjoy your stress-reducing bath!
Tip: You can add a tablespoon of dried lavender flowers.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181830/
https://www.endocrineweb.com/conditions/adrenal-disorders/adrenal-fatigue
https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response