Adrenal burnout is common in fibromyalgia and can really worsen fatigue and fog. Adrenal burnout (also referred to as adrenal fatigue) stems from overworked adrenal glands. The hyperactive stress response in fibromyalgia causes the adrenal glands to work hard—all the time. The continual bombardment of stress response on the adrenals in fibromyalgia forces them to try to pump out cortisol at a high rate continuously. This results in overworked adrenal glands that never get a “rest” period until they “burn out” and start secreting cortisol in abnormal patterns.
There are two ways to diagnose adrenal burnout. One is to look at symptoms. If you have many of the symptoms listed above, especially the ones in italics, this is a strong indication that adrenal burnout may be an issue for you.
Symptoms of Adrenal Burnout
Low blood pressure/dizziness
Feeling shaky/irritable when you are hungry
Frequent thirst Fatigue Brain Fog Feeling faint when standing up quickly Nausea
Low libido Dark circles under eye Multiple food or environmental sensitivities
The more scientific way to assess the function of the adrenal glands is to look at the pattern of cortisol secretion by measuring saliva levels four times in a day, at around 7am, 11am, 5pm, 10pm. Any deviation from the normal cycle indicates strain on the adrenals. Most fibromyalgia patients show mild adrenal burnout with a flattening of the usual curve of hormonal release throughout the day. Several studies have shown this “blunting” of the normal pattern of cortisol secretion in fibromyalgia patients (studies here, here, and here).
My treatment approach to adrenal burnout
I treat adrenal burnout with a combination of supplements for at least two months, ideally three months. Several vitamins and minerals are used heavily by the adrenal glands and need to be supplemented for adrenal support. This is just a general guide and must be adapted to your own personal health situation, so please consult with your personal health care provider before starting any new treatments.
SR Adrenal: an herbal, glandular and minerals that boosts adrenal function. Take 2 capsules with breakfast and 2 capsules with lunch
ONE MVI, a high quality multivitamin that includes the activated form of folic acid called L-5MTHF for nutritional support to adrenals. Take 1 capsule with either breakfast or lunch.
Buffered Ascorbic Acid 1000mg, 1 capsule with breakfast, lunch and dinner
Magnesium Glycinate 120mg capsules, 1 capsule with breakfast and lunch, 2 capsules with dinner and 3-4 capsules at bedtime. If this amount of magnesium gives you loose stools, lower dosage to whatever you can tolerate orally and then apply magnesium cream topically several times daily to legs and feet.
Healing our adrenal glands takes time
Don't expect instant results—it usually takes at least 2-3 weeks of taking supplements before noticing results. I tell my patients to think of their adrenals as a bowl that they are trying to fill with sand- but they can only put in a pinch of sand at a time, so the supportive nutrients must be given to your adrenals multiple times a day in small amounts. Cases of severe adrenal dysfunction may require six months to a year of this extra support.
In addition to supplements there are other important actions to take for adrenal burnout:
Nutritionally, we can support adrenal glands by eating well and emphasizing protein with every meal, and by limiting stimulants like caffeine, sugar, and alcohol.
Drinking plenty of water, and increase salt, especially sea salt. I like to add 1/2 teaspoon sea salt to 16 oz. of water twice daily (it should be dilute enough that it doesn’t taste salty). This sea salt water help increase blood pressure by keeping more fluid in your bloodstream and supplies needed minerals to the adrenal glands. Drinking it is useful to stop the “peeing all the time and still feeling thirsty” feeling that is so common in fibromyalgia. If you don’t want to drink sea salt in your water, you can liberally add sea salt to your food along with increasing water consumption. Don’t add sea salt if you have high blood pressure, however.
Reducing stress by activating your own relaxation response with deep breathing, gentle stretching and doing things that give you joy.
CBD or cannabidiol is also very supportive for the adrenals, and can be useful to add in to any adrenal support protocol, especially if symptoms of anxiety are a big issue for you, with dosing of CBD tincture of 5-20mg up to four times daily.
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