For me, 2024 has been characterised by stress.
I do too much. I run a skeptics in the pub group with events and socials, a magazine, a podcast, a conference, I give talks at skeptics in the pub groups all over the country, I do undercover investigations that I sometimes travel to. I have a job that involves the peaks and troughs in workload that are common when you’re wrangling academics, and it is seriously under-resourced, so I pick up lots of various odd jobs and side projects – often travelling to engage with events and meetings, requiring lots of task or role switching, which is often extra challenging for us neurospicy folks. I work on an entirely separate side project with some academics in Scotland, again requiring travel.
All of those plates are challenging to spin at the best of times, but on top of that I have ongoing health issues that come with a whole chunk of admin and emotion. I actually wrote this piece from my bed while dealing with neck pain.
As much as this sounds like me complaining – it really isn’t. I love that I get to do a bunch of exciting, varied, important and interesting things with my job, with the various other projects I work on and all the skeptical activity. I feel incredibly lucky to be able to do stuff I love doing.
In a way, I thrive on stress – it helps me get things done. And I also know that everyone on the planet is stressed in one way or another. Whether it’s financial, parental, or disability… or more likely a combination of different stresses all layered on top of each other until it feels like we can’t cope. Humans are a stressed bunch, and these are particularly stressful times.
The list of symptoms associated with chronic stress is long and can include anxiety, depression, headaches or dizziness, muscle tension or pain, heart disease, high blood pressure, strokes, and problems with digestion, sleep, sex, weight, memory and focus. Stress can cause us to be irritable and snappy, to sleep too much or too little, to eat too much or too little, to avoid certain places or people, and to turn more to habits like drinking or smoking.
That’s why I find how we talk about the consequences of stress particularly problematic. We see news articles all the time with headlines like “Stuck in fight-or-flight mode? 5 ways to complete the ‘stress cycle’ and avoid burnout or depression”. Meanwhile, there are constant news articles telling us that study X showed that chronic stress will reduce your life expectancy. Or give you a heart attack. Or make your hair fall out, or your toes fall off.
On top of all that, according to a whole range of ‘wellness’ people, chronic stress can exhaust your adrenal glands. This is rooted in the false notion that the body is such a finely-tuned machine that we can overwhelm it with toxins or chemicals, and it simply won’t know what to do with those things.
Adrenal fatigue has become the popular explanation for burnout. It’s not that we’re exhausted from doing too much, or that our mental health is suffering and can cause physical symptoms, or even that we have another underlying health problem that we should get investigated – no, apparently, it’s adrenal fatigue. According to an article in Goop:
Common symptoms of adrenal exhaustion are a general lack of energy, difficulty sleeping, clouded mind, depression, weak immunity with frequent colds or other infections, and difficulty digesting. But pretty much anything else can go wrong when our adrenals are exhausted, such as infertility, low blood pressure, and anemia.
Many of those are actually symptoms that we know chronic stress can cause – but they’re not due to an entire organ in our body collapsing.
The adrenal glands
The adrenal glands sit on the top of each kidney. Their job is to produce a variety of hormones that the body needs to function, some of which are an important part of our stress response.
When humans encounter stress there are two main pathways that help regulate our response. The autonomic nervous system – that’s your flight or fight/rest and digest system – and the hypothalamic-pituitary-adrenal (HPA) axis. Both of these systems can stimulate the adrenal glands to do their thing and start producing relevant hormones to help us handle the stressful situation.
These two pathways stimulate a range of different responses and feedback loops. It’s a finely tuned and complicated system that can affect basically the entire body.
Hormones are important signalling molecules in the human body because they can act at long distances. Many others only interact with nearby cells, but hormones spread great distances through our blood supply and cause changes all over the body. Hormones produced by the adrenal glands at the top of the kidney can therefore trigger a response in our brain.
There are lots of hormones and other signalling molecules that are triggered by stress pathways. One is adrenaline, a hormone that increases blood flow to muscles and triggers the release of glucose so there’s more energy available for those muscles. It also dilates our pupils and airways and increases our heart output, allowing us to get ready to fight or to run away from danger.
The other hormone we hear a lot about is cortisol. Cortisol is also involved in the fight or flight response, but it’s also important for generally managing our stress response. It essentially tells the body, “Look, we’ve got some sort of imminent danger so let’s turn down some of our longer-term survival processes to focus on the immediate threat”. Cortisol reduces our immune function, alters our digestion, increases our glucose metabolism and it can even decrease bone repair and increase muscle breakdown with long-term exposure. It’s also important for day-to-day regulation in the body, and follows a circadian rhythm – meaning we have more or less of it depending on the time of day.
These systems are indeed incredibly finely balanced – our bodies are constantly adjusting and tweaking things according to a range of different stimuli, including the presence of these hormones in the first place. Too much of a hormone for too long, and the body will try to bring the levels down; too little, and it’ll bring the levels back up. Homeostasis is what our bodies do.
Inappropriately high cortisol levels can, for example, have long-term effects on the whole stress system. Studies have even shown that after periods of high stress – like famines – the offspring of people who experienced that stress have genetic changes that impact their stress response. It’s these sorts of long-term changes that wellness people cling to when they discuss things like adrenal fatigue.
Adrenal fatigue
The term “adrenal fatigue” was coined in 1998 by chiropractor James Wilson, and further described in his 2001 book “Adrenal Fatigue: the 21st century stress syndrome”:
Adrenal fatigue is a deficiency in adrenal gland functioning that can result in debilitating symptoms ranging from lethargy to lowered sex drive to weight gain. James Wilson draws on 24 years of clinical experience [that’s clinical experience as a chiropractor] and research to help readers determine if they have adrenal fatigue and learn how to treat it. Beginning with a diagnostic questionnaire, he moves through the causes, symptoms, and treatment of the condition through lifestyle and dietary modification.
Except, adrenal fatigue doesn’t actually exist. There is absolutely no evidence to support this theory. It has been examined, and debunked or disputed, by experts in the field. Adrenal insufficiency does exist, but those who have experience it suffer serious health consequences far beyond those we attribute to stress.
Addison’s Disease is a condition usually caused by an autoimmune response, where the body’s immune system attacks the adrenal glands. It comes with a huge range of symptoms including: fatigue, malaise, muscle and joint pain, reduced appetite, weight loss, increased sensitivity to cold, nausea, abdominal pain, vomiting, craving salty foods, low blood pressure that leads to dizziness upon standing, and hyperpigmentation in the skin. In women it can cause dry and itchy skin, loss of armpit and pubic hair, and reduced sexual drive. Left untreated, Addison’s Disease can cause severe, penetrating pain, bouts of vomiting, loss of consciousness, slurred speech, and convulsions; it can lead to adrenal crisis, which is life threatening.
Addison’s Disease is a specific, defined condition we can identify and treat, whereas adrenal fatigue is just not supported by evidence. That doesn’t mean that people who believe they have adrenal fatigue aren’t experiencing symptoms of fatigue, or burnout, or another health condition – but, by focusing on a debunked condition, we lead people away from getting a diagnosis of something they might actually have and towards a treatment plan that is useless to them.
How not to treat ‘adrenal fatigue’
If you scroll through TikTok and hear mention of adrenal fatigue, cortisol cocktails are probably not far behind. Proponents claim that you can boost your cortisol levels with supplementation. They claim it will help you lose weight, boost your energy, help with carb ‘craving’, reduce panic attacks.
One wellness blogger describes their recipe:
Adrenal cocktail – AKA “Orange Creamsicle” – is a magical elixir that supports hormone balance, HPA axis health, and blood sugar regulation… The central theme here is balance. We want to make sure that we are supporting our body’s natural ability to regulate blood sugar, increase insulin sensitivity, and improve metabolic flexibility.
Her recipe includes four to six ounces of freshly squeezed orange juice, two tablespoons of coconut milk or cream, one scoop of collagen, and a generous pinch of sea salt. Most recipes include coconut water and cream of tartar, orange juice and salt. These are claimed to increase your levels potassium, vitamin C and sodium. Others involve a complicated series of powders and elixirs to boost the power of the drinks. And, of course, those powders and potions cost a lot of money and are sold by a wide range of wellness companies.
These cocktails, potions and elixirs are nonsense. They’re probably not going to cause too much direct harm – they’re pretty safe ingredients – but the reasons people turn to these solutions are indicative of a wider problem.
As I mentioned earlier, we experience significant stressors on a daily basis, and things only feel like they are getting worse. Many of those stressors are caused by things outside of our control like stressful jobs, or financial difficulties when welfare support has been significantly reduced. But, if we go to our employers to help with stress at work, we end up on courses that tell us to manage our own stress by writing lists or practising good work life balance – but without any meaningful support in encouraging our employers to reduce our workloads.
We are constantly told that stress will kill us early, but if we’re too stressed it’s apparently our own fault. We need to work harder at “relaxing” – an oxymoron if ever there was one. We need to prioritise our sleep – some employers will even pay more if we sleep more – but “trying” to sleep better is a sure-fire way to make sleep impossible if you’re someone who already struggles with it. The guilt and responsibility is piled on to us as we’re told to not feel stressed or anxious about it. Mental health waiting lists are growing, and private therapy is an expensive minefield.
There are no readily available solutions, there is inadequate support.
So if someone on TikTok tells you this one simple trick to help you make it through the day with a little more energy, with fewer panic attacks, and without the stress you have little control over harming your body – who wouldn’t want to try that? Plus, you say, it’ll help me lose weight and feel a bit better about my body, too? Great. Sign me up.
Of course people are turning to woo. Our stress systems are broken. But the cause absolutely is not what’s happening in our adrenal glands, it’s what’s happening out there in the world around us.
