肾上腺疲劳：这是真的吗？

肾上腺疲劳是一个在健康界流传了多年的名词。它’在功能和中西医领域尤为常见。也许你’ve heard of the term while browsing the internet or reading a book. Or maybe 您 were diagnosed by a healthcare professional with 肾上腺疲劳 您rself. Some people say 肾上腺疲劳 is a real 诊断 and some say it isn’t. So, is 肾上腺疲劳 real? Is it an actual 诊断 that can be 对待ed?

什么是“adrenal fatigue?”

肾上腺是我们的下丘脑垂体肾上腺（HPA）轴的最后一部分。 HPA轴负责您的压力响应，也就是您的战斗或飞行响应。 （这里’s a 2 minute 视频 解释HPA轴。）这两个小腺位于肾脏的顶部，并产生各种激素。这些激素之一是皮质醇。当我们的身体承受压力时，肾上腺会产生少量皮质醇并将其释放到血液中。皮质醇可做很多事情。它有助于调节血糖水平和新陈代谢，减少炎症，并调节记忆形成。在压力时期，皮质醇会增加心率，血糖，呼吸和肌肉紧张。皮质醇还可以关闭身体’s systems that aren’在危机时期是必要的。我们需要皮质醇才能生存。

The term 肾上腺疲劳 is used often in the media and by functional medicine clinicians to describe a condition in which someone experiences chronic, repeated exposure to stressful conditions. The repeated exposure of stress over time causes overstimulation of the adrenal glands. Eventually, the adrenal glands fail to function like they should.

有什么症状“adrenal fatigue?”

The two most common symptoms associated with 肾上腺疲劳 are tiredness and low energy. 其他 symptoms include brain fog, lack of motivation, depressed mood, and having trouble getting out of bed even after getting an adequate amount of sleep.

The problem is that fatigue and low energy are such general symptoms and many, many people go to their health care provider (HCP) with these symptoms seeking help. These generalized symptoms are associated with many medical problems, making it challenging to nail down a specific 诊断. Anemia, autoimmune diseases, thyroid problems, mood disorders, problems with major organs, infections, sleep disorders, etc. are associated with low energy and fatigue.

当您查看自己的HCP时，他们会获得完整的历史记录，进行身体检查并下达诊断测试以帮助确定诊断。具有疲劳，精力不足，缺乏动力等一般症状（与“adrenal fatigue”）通常不是’很有帮助，几乎没有答案。体检正常。血液检查正常。这可能会使您，患者以及医疗保健人员感到困惑和沮丧，因为对于您的症状没有明确的答案’重新体验。告诉某人他们真的很诱人“adrenal fatigue”解释他们的疲劳和低能量的普遍症状。也许你’ve heard, “There’你没错。” or “It’s all in 您r head.”作为患者，这也确实令人沮丧和无效。

How is an 肾上腺疲劳 诊断 made and is it valid?

诊断这种现象的医生使用病人’s reported history and symptoms along with laboratory tests to make a 诊断. This is problematic in many ways. These symptoms are so incredibly general. As far as the research goes, there is no validated symptom score to assess these symptoms. In contrast, the PHQ-9 and PHQ-2 are well researched and valid assessment tools used in primary care and mental health settings to evaluate mental health. 那里 is no such tool for assessing 肾上腺疲劳。 那里 are also lab tests used in naturopathic/functional medicine settings and tests marketed on the internet to detect 肾上腺疲劳。 Unfortunately, there is no compelling data to validate these tests. The same goes for hormonal tests and food allergy tests marketed on the internet and used in these clinical settings. Just because a test is offered, doesn’t mean it’s valid.

我认为它’s important to note that 肾上腺疲劳 and adrenal insufficiency are not the same. Adrenal insufficiency is a well researched and legitimate medical condition that has defined symptoms and can be diagnosed with laboratory tests.

研究怎么说

那里 was a systematic review published in 2016 exploring the validity of 肾上腺疲劳。 Systematic reviews are the cream of the crop when it comes to research. They give us the highest quality evidence. The review published included 58 studies and found no evidence for the 诊断 of 肾上腺疲劳。 As of now, we have no formal criteria to define what 肾上腺疲劳 is nor do we have criteria to diagnose 肾上腺疲劳。 如果你 want to geek out, 您 can read the full review 这里.

The symptoms 是真实的, 肾上腺疲劳 is not

尽管出现这些症状并被告知确实令人沮丧’都在您的脑海，知道这一点：您的症状 是真实的. What 您 feel 是真实的。它’s just that 肾上腺疲劳 is not a real 诊断. Not having a biological explanation for symptoms can be frustrating, disappointing and emotionally draining. Mental health diagnoses like anxiety and depression can manifest symptoms similar to those associated with 肾上腺疲劳。 Especially in today’在快节奏的社会中，感到焦虑和/或沮丧是很常见的，而且您并不孤单。我知道！如果您觉得自己遇到的症状是由于“adrenal fatigue” I’d鼓励您退后一步并进行反思。您生活中的压力源是什么？您的睡眠卫生如何？您的心理健康状况如何？您的情绪健康吗？您从事的锻炼是否有助于您减轻压力或减轻压力？

对的建议“treat” 肾上腺疲劳 have the potential to do more harm than good

Although getting a 诊断 for a medical condition 那没有’t actually exist isn’t good medicine, it’s the recommendations to follow that have the potential to be quite harmful. 如果你 google 肾上腺疲劳 您 will find pages and pages of information that I 认为 actually cause more psychological distress and confusion.

如果你’重新感到疲劳和压力， 您需要做的最后一件事是要做更多的事情并进行修复. The recommendations for 肾上腺疲劳 are cloaked in diet culture. The primary recommendation is to cut out a bunch of foods from 您r diet –从根本上消除饮食。营养处方是消除所有加工食品，糖，乳制品，面筋和淀粉类碳水化合物。节食是让您的身体承受最大压力的事情之一– emotionally, mentally and physically. 那里 is also a slew of supplements to take and other alternative therapies to embark upon. I’我更强调只输入那个。

我担心的不仅是缺乏支持这些极端建议的证据。我也担心这些的巨大潜力“adrenal fatigue”治疗建议，以保持饮食失调的习惯和更多的压力。当然，高压力不会’对我们的长期健康而言是一件好事。压力过大可能而且很可能会对我们的健康产生负面影响。将所有这些一般症状打包成非法诊断，然后“treating”在没有科学依据的其他建议中，消除饮食的状况是一个问题。它’过度简化了一个更大的问题，使人们“protocol”解决更复杂的问题。当生活中的其他部分失去控制时，控制食物似乎确实很诱人。当我们感到压力太大和精神不振时，遵循准则和步骤确实会令人感到安慰 ’确定下一步要去哪里。

What 您 can do instead

这些建议是’黑色和白色。他们不是’t a 协议. 如果你 sat these recommendations next to the “肾上腺疲劳解决方案” book, 您’d出售更多的副本“solution” because it’对人们更具吸引力。节食确实可以卖。他们只是不’t work.

• 坐下来 弄清楚您一生中实际需要做的事情 versus what 您 认为 您 need to do.
• Prioritize 您r sleep –每晚至少需要7-8个小时。
• 设定界限 在你的生活中。你在说什么呢？该列表应该非常小。保护您的同意！
• 全天定期补充各种食物来滋养身体。 If 您 don’t eat 3 meals a day, start there. 如果你不这样做’不要饿了，每天要吃三顿饭和三顿零食（所以你’每4个小时重新进食）是个不错的起点。
• 喝咖啡，但是 午餐后选择咖啡因以外的其他食物。 当天晚些时候，咖啡因会使您难以入睡。如果你依靠咖啡来“通过一天”退后一步，弄清楚需要做什么才能不依赖咖啡因。
• 喝水！至少64盎司听起来很基础，但是很多时候补水一直是缓解症状的关键。
• 与让您感觉良好的人共度时光。 在我们的心理和情感健康方面，与能增加您的生活（而不是带走生活）的人在一起可以使自己动起来。
• 重新评估您的运动习惯。 您是否将运动作为惩罚？正在锻炼您认为有义务要做的事情，或者被视为锻炼“should do?”在锻炼之前或之后您是否精疲力尽？如果有任何共鸣，我’d确实鼓励您从故意锻炼中退后一步。步行。和您的孩子或狗一起玩。做一些放松的瑜伽。这里’s 一个帖子 改善与运动的关系。
• Start a 正念 practice. 听起来不错，我明白了。我不’与这个词产生共鸣“mindfulness” as much as I do “chill out.”睡前在地板上伸展10分钟，早上不带手机散步，或深呼吸60秒钟。
• 从设备和屏幕上拔下电源。 技术真棒，但它也会使我们混乱，因为它使我们不断受到刺激。

最后的想法

压力是真实的。它肯定会影响我们的健康。您的症状也是真实的。尽管上面的列表并不详尽，每个人’的旅程会有所不同，希望本文和这些技巧为您提供一个起点。记住，慢步走。变化本身就是压力大的。从一项更改开始，并在一两个星期的时间内实施它。当你’准备好之后，继续进行其他易于管理的工作。随着时间的流逝，所有这些微小的变化将帮助您过上与您的价值观一致的健康，快乐和更加真实的生活。

如果你’d like，您可以注册 这里 为我提供的有关治疗激素的免费迷你电子邮件课程–它为您提供了一些起点和实践步骤，使您在身体，心理和情感上都能感受到自己的最佳状态。