by Dr. Laura Markison
With so many changes in the last year fatigue is getting blamed on stress and lifestyle changes due to the pandemic. Of course, this is a very valid reason for fatigue. But why are we fatigued? What is happening physiologically to our bodies? And is it all about stress or is the nature of aging adding to our fatigue?
Stress response: When we are feeling stressed our body produces a hormone called cortisol. Cortisol gets a bad rap for this known effect but what else does cortisol do?
Cortisol is made by our adrenal glands. Adrenal glands are small fatty like caps located on top of our kidneys. Most of our cells in our body have receptors for cortisol. Cortisol helps regulate our metabolism, sugar levels, reduce inflammation and control blood pressure by regulating the salt/water system in our cells. It is also essential for fetal development. So, cortisol is a very important hormone for our bodily functions and our feeling of wellbeing.
Cortisol patterns of disruption: Cortisol rises in the morning hours and is what helps us wake up. As the day progresses it lowers and should be at its lowest at bedtime so we can fall asleep. When the adrenals are stressed cortisol can be too low in the morning and we feel sluggish reaching for caffeine to wake up. Then as we stress more during the day cortisol rises too high and now it is too high and interferes with the ability to fall asleep. After this stressful pattern, the adrenals can become truly exhausted (especially from excess caffeine intake) and now true adrenal fatigue causes exhaustion.
When our cortisol rises due to stress or steroid use (like prednisone or even topical corticosteroid creams) use, we gain weight, can become depressed, our sex hormones get depleted, and some people develop Cushing syndrome or some people can develop Cushing disease from a tumor on the adrenal gland. Too much cortisol can also lead to osteoporosis (another side effect from taking steroids long term). Too much cortisol can also impact your skin.
When our adrenals are taxed from long term stress they shrink, and we become tired. Adrenal fatigue is a true urgent medical condition that can easily be treated once properly diagnosed.
But let’s talk about fatigue due to depleted hormones. A lot of people in their forties and fifties (I have some younger patients, also) have depleted thyroid and sex hormones. When estrogen and testosterone become deficient fatigue can set in. Now not only do we feel tired all the time, we start gaining weight, feel “grumpy”, lose interest in sex, and just plain feel terrible. When thyroid hormones are depleted, we can lose our hair, feel cold all the time, gain weight, and have difficulty exercising.
With all these different reasons for feeling fatigued we start to blame ourselves for “lack of motivation” or “I must be a lazy person”. This negative chatter sets off self-hate and depression that then leads to more fatigue. What if it’s not “YOU” but your hormones? Why not come by for a hormone assessment to see if your fatigue is truly from lifestyle changes due to the pandemic or due to a physiological reason that has slowly created a nagging fatigue that can’t be remedied by caffeine or even rest. Let’s stop the negative self-chatter and see if your hormones are too high (cortisol) or too low (hypothyroid or low sex hormones). Did you know stress can also impact your skin health?