Nici Wickes knew she was tired. Not just a wee bit tired, she felt like the walking dead. So much so, that when she happened to drop a newspaper or a teaspoon on her living room floor, she couldn’t find the reserves to pick it up.
“I’d say to myself, meh, I’ll get that later.”
A week down the track the teaspoon would still be there, glinting sadly on the floor.
“It was demented. I knew it wasn’t normal to be feeling this exhausted. People would say, Oh you’re depressed. Well, of course I was, but only because I wasn’t getting enough rest to restore my energy levels. I knew my headspace was fine, it was just the exhaustion that was getting to me.”
Nici, host and cook for food-travel show World Kitchen and weekly columnist and food editor for the New Zealand Woman's Weekly had always enjoyed a busy, upbeat lifestyle, but whatever was causing her to wake up exhausted was getting in the way of living.
Her first port of call was the doctor’s office. She was tested for Hashimoto’s disease, an autoimmune condition that attacks the thyroid gland. The disease leads to signs and symptoms mainly of an underactive thyroid gland (hypothyroidism), the main problem being tiredness. But Nici tested negative for Hashimoto’s.
The doctor’s response to Nici’s symptoms were mildly patronising, she says.
“Oh look everyone’s tired ... you’re not 25 anymore ... you lead a busy life.”
“It was just so frustrating. I needed someone to believe it was something other than just getting older.”
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Advertise with NZME.It wasn’t until Nici saw a naturopath, who suggested she might have adrenal fatigue, that her condition started making sense to her.
Alternative health providers believe given enough stress, or as a result of infection, the adrenal glands become exhausted and are unable to produce adequate cortisol the steroid hormone made in the adrenal glands then released into the blood.
Cortisol’s role includes controlling the body’s blood sugar levels and thus regulating metabolism, as well as anti-inflammatory benefits, memory formation, controlling salt and water balance and influencing blood pressure.
Adrenal fatigue otherwise known as hypoadrenia is a contentious condition, however, not recognised by the medical establishment. The condition was named in 1998 by chiropractor James Wilson.
The main symptom is fatigue not relieved by sleep and not caused by low iron or vitamin B12.
Alternative health providers often offer blood or saliva testing to check for cortisol levels (lower levels supposedly suggest adrenal fatigue), but there is no firm evidence that adrenal fatigue can be tested through these methods, let alone exists at all.
It’s not the first time naturopaths and their theories have been dissed by the medical establishment, and it won’t be the last.
“We are like the ambulance at the bottom of the cliff,” says Kaytee Boyd, owner of the Boyd Clinic in Ponsonby, which offers personalised wellness programmes with a focus on nutrition and cancer, chronic illnesses, stress and adrenal fatigue, hormonal imbalance and gut and food allergies.
“Often people see me after they have tried doctors and specialists; when they can’t seem to get an answer as to why they’re so tired.”
Kaytee, who holds a double degree in human nutrition and sports science, is a staunch believer that any disruption to the adrenal glands, along with the hypothalamic and pituitary glands, otherwise known as the (HPA) axis, can have long-reaching effects on maintaining alertness and modulating sleep.
“Adrenal fatigue is a bit of an outdated term,” she says, the focus is now on HPA dysfunction, and there is plenty of research supporting the idea that any dysfunction of this axis can disrupt sleep.
“Anyone interested in the research should Google ‘HPA dysfunction, Pub Med’.”
The papers that appear, published in journals such as The Journal of Clinical Endocrinology and Metabolism, Scandinavian Journal of Psychology and Psychiatric Clinics of North America, discuss the many effects of HPA dysfunction and its connection to stress- related exhaustion, depression and sleep problems.
And yet another review through this search concludes adrenal fatigue does not exist.
Whatever doctors and naturopaths disagree upon regarding the causes of such fatigue and sleeplessness, most of us are more interested in whether we can do something about it which to some extent requires an understanding of how our hormones and stress levels affect our circadian rhythms.
To understand how cortisol plays an important part in circadian rhythms, Kaytee says in most people a good sleep will lead to rising cortisol levels, so when you wake you have the energy to face the day.
In people with adrenal dysfunction, they might not be producing enough cortisol, either because constant stress puts their body into fight mode and they are no longer able to produce enough cortisol, or in other cases, cortisol levels might rise during the day, leading to an inability to sleep at night.
What most agree on however is an interruption to the circadian rhythm can lead to sleep disruption and tiredness, and has negative impacts on the stress system.
Naturopath Sharlene Bennett, who works for Good Health NZ, says she has recently seen a surge of patients with problems relating to exhaustion, weight gain, sleep disruption and stress.
She blames an overstimulated environment, too much sugar, coffee, alcohol and processed foods.
“Our bodies are only designed to cope with short-term stress. Now we are faced with stress 24/7 due to technology that allows us to always be on-call. We also have very high expectations of ourselves.”
Kaytee says the use of devices at night is a huge factor in disrupting our circadian rhythms, and the resulting sleep problems.
“That blue spectrum light on your iPhone is telling your brain to get up! I tell all my patients to turn off their devices by 8.30pm and put them on night mode. Another negative impact of technology and social media is the dopamine [the reward hormone] rush that we get from receiving a text or perhaps a Facebook ‘like’, which keeps us coming back for more.”
Added to this, there is research that suggests dopamine, normally increased at times of stimulation, can directly inhibit production and release of melatonin, the molecule that induces drowsiness and prepares the body for sleep.
So, enough about fatigue and stress, how do we negate their harmful effects? Sharlene recommends moderate exercise that allows you to breathe quietly (spin classes, no thanks we’re talking yoga, pilates and walking).
A healthy diet with more vegetables and unprocessed foods is a factor, of course, as is the less obvious: listening to music, cuddling a pet, art therapy, or a hobby you enjoy.
Kaytee's more in-your-face advice is to “slow the **** down!”
“I tell my patients put your fork down between mouthfuls, make time for yourself, even if it’s just 15 minutes.
“Laugh go to a comedy show. Laughing has been shown to decrease the fight or flight response. And regular sex increases your oxytocin [feel-good hormones].”
And for those without partners, she trots them down to sex store Peaches and Cream.
“Do at least one pleasurable thing a day!” We get the drift.
Offloading also helps de-stress she says, and if you can’t find someone to talk to, try writing a journal.
“Try creating a new CV. If you are in a job rut, it will push you to interview for a new job. If you are in a toxic or verbally abusive relationship, learn how to leave.”
For Nici, just the validation and acknowledgement that something wasn’t right was a huge help.
Then, with the guidance of a naturopath, she worked hard to reduce her stress levels and create a calmer life.
“I’m learning how to say ‘no’ to people. I wrote a list of people and tasks that sap my energy unnecessarily. I bit the bullet and employed a cleaner, I’d always felt guilty for thinking I needed one, but I found that restoring order made me calmer.”
A good dose of silence also helped. Instead of listening to the radio all the time (she’s a huge National Radio fan), she turned it off and allowed herself to have silent time during the day.
Nici also takes iodine which she says made a world of difference. Iodine is a mineral the body needs to make thyroid hormones. These control the metabolism and many other important functions. She also says vitamin D helps, but the key to reducing her exhaustion has been to “calm the hell down”.
“I’d always been an excitable person, but I think my body was tired out by all the stimulus.”
Her yoga teacher told her to tell the shouty side of her brain to be quiet.
“The sympathetic, or fight-or-flight, side of my nervous system was too loud.”
Nici learned to calm herself through yoga and meditation, went to a course on mindfulness conducted by Anna Friis, and now and then she'll rub her arms up and down. "It produces oxytocin she tells me.
“We also get it by hugging children, it’s why we hug them when they’re upset, as it calms them down.”
Now Nici will plan so she can get some down time after a big event, but like many problems we face in life, she says it’s a case of constant management. “We’re on 24/7 these days. I don’t think I’m alone in this.”
One more thing, she adds. “We need to lower our expectations about how much is possible.
My situation showed me that when we give ourselves grace and space in our lives, we end up creating and innovating far more than when we are struggling to stay on the treadmill.” And, of course, are far less exhausted.
