87. Beyond Burnout: How Adrenal Fatigue and Cortisol Imbalance Hijack Your Hormones

You’re not lazy. You’re not crazy. And it’s not just stress. If you’re exhausted, your periods have gone haywire, and your labs come back “normal,” you might be dealing with something deeper—adrenal fatigue. In this episode, Dr. Monica Minjeur shares Rachel’s story of burnout and recovery, exploring how chronic stress and cortisol imbalance can wreak havoc on your hormones. There is hope. You can restore your energy, your cycles, and your sense of self.

Transcript

Monica: 0:02

Welcome back to Cycle of Wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. Have you ever felt like you're doing everything right, eating well, exercising, managing stress as best as you can? Yet, you're still exhausted. Your menstrual cycles are irregular, and you just don't feel like yourself. Maybe you've been told that your labs are normal, but you know that something is off. You are not lazy, crazy, or making it up. What if the problem isn't just in your ovaries or your thyroid, but in the very system your body uses to respond to stress? Your adrenal glands. Today we're diving into how adrenal health plays a critical role in women's health, fertility, and overall wellbeing. And we'll get started with Rachel's story, a story about a teacher whose burnout and cycle problems were more than just stress. They were a sign that her body needed help. You are going to want to hear how we work together, so let's get started. Rachel came to us as a 36-year-old full-time teacher. She's the mom of two young kids who were very active, and she was a former runner herself. Rachel came to our clinic after months of debilitating fatigue. She had trouble getting out of bed in the morning, had some brain fog that made it difficult to focus on her students during the day. She had irregular cycles and a complete loss of libido. She had been to three different doctors who all told her she just needed to decrease her stress levels, or she was probably perimenopausal or the worst of all. This is probably just normal mom life. Rachel cried during her intake visit and said, I feel like a shell of myself. I used to thrive on my schedule, and now I'm barely making it through the day, much less feeling like I have anything to give to my family. We started off as always with getting Rachel started on charting her cycles and then ordering labs that were timed to her cycle. Her initial testing revealed low morning cortisol levels, imbalance in her DHEA levels, low progesterone, as well as decreased levels on multiple other things that come after DHEA. Rachel wasn't perimenopausal. Her adrenals were overworked and depleted. We worked together over the course of the next few months to adjust her nutrition to support adrenal repair. We overhauled her sleep hygiene schedule and continued to have her tracking her cycle to monitor the hormone shifts that take place. We worked on some supplements as well as prescription strength medications to help support that adrenal function and slowly reintroduced some gentle movement activity. We also got her working with one of our health coaches for weekly check-ins to work through how to reduce stress in a meaningful way. After about five or six months, Rachel realized that her cycles had been more normal. She reported her energy levels had improved and her moods had stabilized, and she was even able to go on a weekend hiking trip with her family without crashing. She said to us at her follow-up, I didn't realize how bad it had gotten, and now I feel like I'm actually living again. So what are the adrenal glands and why do they matter? Now, most people have heard about cortisol and we know that it can be a stress response, but many people don't realize where cortisol comes from and how it plays a role in our body. So put in the most simple matter. Let's start with your adrenal glands. Your adrenal glands are located right above your kidneys. You have two of them located in the mid upper part of your back. Three adrenal glands are responsible for many different functions in your body, but primarily responsible for regulating your blood pressure, regulating your metabolism, your stress response, as well as hormone production. Yeah. Now the two main hormones that we talk about that are produced and managed by the adrenal glands are going to be cortisol, like we mentioned, that primary stress hormone that most of us think about, and DHEA, which is dihydro. Epi androsterone, now, DHEA and cortisol work hand in hand in order to respond to stress and to create additional hormones. For example, if your body is a going. Under increased amount of stress, your cortisol may actually steal from DHEA for a time being in order to produce more cortisol so that your body can respond to normal activities. Adrenals communicate with your hypothalamus and your pituitary gland as well, which are both located in your brain. And so we have this trifecta, it's called the hypothalamic pituitary adrenal axis, and these three main areas in our body. Regulate many, many of the hormones that go on on a regular basis for general functioning. Now, if the system is not working well, it can create dysregulation and we sometimes will refer to that as adrenal fatigue or adrenal insufficiency, depending upon the severity. We see that when your adrenal glands are not working well, it can cause cortisol dysregulation. And as you've heard me refer to in other podcast episodes, if cortisol is not going well, it can hijack all of the other hormones. And so this can lead to things like irregular cycles. Low progesterone anxiety, mood swings, and troubles as well with fertility struggles and thyroid dysfunction. So the adrenal glands are really crucial as far as monitoring and managing many of the hormones that are produced in your body, but also in regulating how our bodies respond to stress. So what are some common symptoms that we see with adrenal function? The most common things, unfortunately, can be kind of nondescript. So fatigue is a common sign that we'll see with adrenal dysfunction. So maybe you're sleeping well at night, but you wake up in the morning and you're still just exhausted. This can be a sign of adrenal dysfunction. Energy crashes in the afternoon. So maybe you go along throughout the morning, okay? But you find that in the middle of the afternoon you just hit a wall. Now, this can also be a symptom of thyroid dysfunction, so it's really important to understand not only how the adrenal glands and the thyroid can work together, but how there can be a lot of overlap with symptoms. And so this is why it's really important to know what it is that we're looking for and cover all of our bases. Other signs specific to menstrual cycle can include an increase in PMS symptoms or irregular periods, which is oftentimes happening if you are not ovulating. Other generalized symptoms can include salt cravings or feeling like you're lightheaded or having a hard time with regulating your blood pressure or blood sugar. Adrenal dysfunction can also cause unexplained weight gain, weight loss, decreased libido. And sometimes feeling dysregulated, like you are tired, but you still have a bunch of energy. So it can be really nondescript. It can be very generalized, but when we start to put all of the symptoms together and then add that to lab testing, that's where we're able to differentiate and say, Hey, this is an adrenal problem, not something else. So what does adrenal health testing look like? Primarily in our practice, we're looking at cortisol testing in particular, and specifically we're interested in testing that morning cortisol we typically should see that levels should spike a bit in the morning to get you up and kicking. So checking that morning. Cortisol lab test is important. We also look at other things like specifically testing A-D-H-E-A level, as well as looking at the other hormones that are derived from DHEA, which include testosterone, Andro, Stine Dion, DHEA, sulfate, estradiol, and many others. And so just the cortisol alone typically isn't enough to give us the whole picture, and that's why we wanna also make sure we're looking at these other hormones. Another important note is that with cortisol, oftentimes we can see that the level may be completely normal when we check it first thing in the morning. And so there are cases where we are looking at what is cortisol doing from a chronic standpoint. So for example, if your cortisol levels are actually really low, that can be a sign that you have had chronic stress and your body is trying to suppress all of that excess cortisol. And oftentimes we'll see a very low cortisol level. If your cortisol level is really high when it's tested, that may be an acute stressor. So for example, maybe you got into a car wreck on the way getting your labs drawn, or maybe you had a really frantic morning. These things can impact cortisol, and so cortisol testing can be a little bit tricky. There are some times individuals that will come in and they will say, Hey, I've had this saliva testing done looking at my cortisol levels at multiple times throughout the day. And the tough thing with salivary levels is that it's a little challenging to get an accurate sense on that because you're having to test multiple times a day, and there's not great cutoffs to know how does that correlate well with what's going on from a lab test. So I will admit that cortisol testing in and of itself can be really tricky, but this is, again, one of those important reasons that we look at not only what do the labs point to, but also what are your symptoms and looking at that whole big picture. So if we've identified that you have some adrenal dysfunction or adrenal insufficiency, what are the ways that we can help to improve that? Certainly, there are some different situations where supplements may be beneficial, but really we're looking long-term to fix the underlying causes and really work towards lifestyle changes that help to improve your overall adrenal health, as well as to positively impact your overall stress levels. So the number one thing that we always talk about is regulating your daily sleep routine. It's important, as much as possible to try and go to bed and wake up at about the same time each day, even on the weekends. Now, I know this can be tricky, and oftentimes people get into a bad habit of sleeping well during the week and then they say, oh, I've earned it. I get to stay up later on the weekends. Or maybe you burn the midnight oil and really get into that book. Or going out with friends in the evenings on the weekends. And this can really do a number on your adrenal glands. First thing in the morning when you wake up. It's important to try and get at least 10 to 15 minutes of natural light to help reset your circadian rhythm, get the melatonin cleared out of your system, and really get up and get kicking for the day and again before bedtime at night, avoiding that artificial light from screens. So turning off the tv, the tablet, the phone, putting it all down at least one to two hours before bed. Or if you absolutely have to be on a screen for work or some other reason to use blue light blocking glasses. This will help your body to trigger melatonin at an appropriate time so that you can fall asleep and hit REM sleep faster. Another important piece that we pay attention to when trying to correct underlying adrenal insufficiency is making sure that we are getting adequate nutrition. One of the best ways to do this is to make sure that you're eating regular meals that have an appropriate amount of protein, healthy fat, and fiber in every meal to prevent blood sugar crashes. I commonly see people come to me that are stressed out and they don't have enough time to eat, and so they oftentimes are skipping meals or sometimes living off of caffeine or those quick sugars or carbohydrates in order to give them the pick me up. Cortisol will oftentimes be spiked by eating those carbohydrates, and then you can have another sugar crash when it's too high, and then the blood sugar drops too low again. So making sure that we have that balance throughout the day is really helpful. Again, that's another point as far as caffeine, is that too much caffeine can mimic or worsen stress. So as much as I hate to say it, and as much as people hate me saying it, we recommend trying to cut back to one cup per day or less on the caffeine. Other things that you can do to help with maintaining general good nervous system regulation, include breath work. So a lot of people will say, well take some deep breaths, but what does that actually look like? So one of my favorite techniques to talk about is box breathing, which means that you breathe in for a certain amount of time and then you breathe out, and then you breathe in, and then you breathe out. And as you're doing this, you can take your finger and you can trace. The shape of what a box would look like or just picture that in your head. Another one that's actually been studied is actually they call it four seven eight breathing, which means you breathe in for four seconds, you hold the breath for seven seconds, and then you exhale for eight seconds. And doing this over the course of a couple of minutes can actually. Create a noticeable decline in your cortisol levels. So breath work is not just about take a breath and take some deep breaths and work through it, but really finding ways to use that breath in a meaningful way in order to drive cortisol levels down. Okay, five to 10 minutes of daily mindfulness or meditation or quiet time has also been shown to lower cortisol levels. So whatever that looks like for you, whether that's first thing in the morning, whether that's in the middle of your busy day or when you're trying to wind down for bedtime, but having just that quiet time to think and to be mindful to. Journal to write out gratitudes, to pray, to meditate, to think on what happened throughout my day, whatever that looks like. And then the last one that's really interesting is trying to activate your vagus nerve. So your vagus nerve is responsible for helping to reduce stress load. And so ways that you can activate this vagus nerve, which runs through your neck, are going to include things that are going to help bring hum vibration into that area. So think about things like humming, or gargling or singing. All of these things can help to stimulate the vagus nerve and reduce your stress load. If you're going to exercise, we want you to make sure that you're moving gently, not overdoing it. Intense exercise, like long cardio sessions or fast-paced, high intensity interval training can actually increase cortisol if your body is already depleted. So instead, we recommend gentle movement, things like walking, Pilates, yoga strength training. Jogging is okay as long as it's not increasing your heart rate for too much, for too long. So ideally, focusing on when can I get that gentle movement in on a regular basis. Again, aiming for about 30 minutes per day, five days per week, and also making sure that you build in time for rest. Setting boundaries and intentionally resting is so important to helping to restore your adrenal function. So practice saying no and no is okay. And one of my business mentors says no is a full sentence and that is okay. Schedule some time in your calendar for intentional rest time or downtime. Schedule it just like you would schedule an appointment and be diligent about making sure that nothing else gets plugged in there. Your nervous system needs time and needs space in order to heal, and most importantly. Work together with a healthcare professional who understands the hypothalamic pituitary adrenal axis dysfunction and can assess cortisol patterns through lab testing, through symptom evaluation, and understanding how that plays a role with the other hormones that are in your body. It is also important to make sure that you're addressing other underlying causes that could mimic adrenal dysfunction, like thyroid dysfunction, nutrient depletion, inflammation, or other hormone abnormalities. Again, remember that your adrenals are central to creating a balance with what goes on with all of the rest of your hormones. And restoring adrenal function can restore not only your cycle health and fertility, but also your energy and your overall health. You don't need to feel burned out to the point of collapse before you seek help. It's not just stress. It's a real physiologic issue that has real solutions. So if you're listening to this episode and you're feeling like Rachel burned out, exhausted, wondering why your labs were all normal, when nothing feels normal, please know it's not all in your head. Your story matters. Your health matters, and your symptoms deserve real answers. At our practice, we don't just treat lab results. I treat people. We do this through a root cause restorative approach to help women uncover what's actually going on with their hormones, adrenal function, and overall health. Imagine if you could finally wake up with energy again, feel like yourself in your own body and get a plan that actually works with your physiology not against it. That's what I help women and couples do every day, and I would love to help you too. You are not alone and there is a better way forward. If you're ready to work with our elite team of healthcare professionals, go to our website, radiant clinic.com to schedule a free discovery call with me and learn more about our package based pricing for comprehensive care. We are currently able to see people for in-person appointments in the Cedar Rapids, Iowa area, or can arrange for a telehealth visit if you live in many different states. Check out our website to see where we are currently able to offer medical services. And if your state isn't on our list, no problem. Get in touch with us and we'll see if that's something that we can add on to be able to care for you. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.