Ep. 127: Debunking “Adrenal Fatigue” with Ari Whitten
Today I’m bringing back my good friend Ari Whitten, this time to talk to us about the real truth of the so-called condition called “Adrenal Fatigue.” There’s a lot of talk about that condition out there, especially in the holistic and functional medical world, but is it really a thing we should be so concerned about? Ari has done the deepest, most comprehensive dive into all the research, science and evidence that has ever been done on the subject. And he shares it all with us. It may surprise you what he has found. This episode will change the way you think and feel about your cortisol levels, your adrenals and what is really in your control for creating and experiencing greater energy and health in your life.
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Robyn: Hi there and Welcome back to the Vibe show. I am your host Robyn Openshaw. Recently I did a three part podcast that really was about how to smell a rat in the health and wellness industry or how to develop your critical thinking skills and what some of the fads are that maybe don’t serve you very well and that are going to take you and your energy down a bunny trail to do things that might be part truth, part fiction or totally fiction.
And I was having a conversation with one of my very favorite colleagues and we were talking about the issue of adrenal fatigue. And my colleague’s name is Ari Whitten. He is a bestselling author. I’m going to do another episode with him about his latest book on Red Light and near infrared therapy and the hundreds and hundreds of published studies showing what this can do for us and how it’s a nutrient that most of us are deficient in the modern industrial age.
So that’s another show to look forward to where I’m going to have a conversation with Ari about this new expertise for him where he’s just an amazing researcher. But today I wanted him to kind of add on to that three part podcast series where I talked about a lot of different fads and ways to evaluate data and hopefully it gave you some ideas on whether to value something very highly or whether to value something not very much at all based on the quality of the data or the hierarchy of evidence. And I went to Ari to talk to him about this adrenal fatigue issue because so many people are talking about this as a diagnosis.
Ari is like I said, an author, he’s a nutrition and lifestyle expert. He was kind of a personal trainer to some very famous people many years ago. But he’s also the founder of The Energy Blueprint. And if energy is an issue for you and you want to dig deeper into what the cause might be if you have a chronic loss in energy, I will tell you how to get more really amazing free information from him in this show.
But Ari is a student of and a teacher of Health Science for over 20 years now. He has a Bachelor’s in Kinesiology. He has certification from the National Academy of Sports Medicine. And he completed like me, he completed his coursework for his PhD in clinical psychology. Neither one of us finished the 4,000 hours of therapy that we needed to do to actually go out there and be psychologists. But we have very similar background and we often talk about what is new, what is to be questioned, what is useful about different trends, philosophies, dogmas, theories out there in the health and wellness world.
So the last five years he’s been really focused on developing The Energy Blueprint system, which I do talk about to Green Smoothie Girl followers about once a year because people see really great gains from following his work. So today we’re talking to Ari Whitten about adrenal fatigue. So welcome back to the Vibe show, Ari Whitten.
Ari Whitten: Thank you so much for having me. It’s such a pleasure Robyn.
Robyn: So I’m very excited to talk to you about this subject because I think it’s going to help a lot of people. They have a vague idea that their adrenals are stressed. They might know a little bit about what the adrenal glands are, but you have done a deeper dive than anybody I know and you’re more than anybody I know, willing to say, Hey, I don’t think what everybody’s talking about out there is quite right. You’ve done a comprehensive analysis of the science related to adrenal fatigue. What is your take on this idea that lots of people have adrenal fatigue and we should be taking specific supplements and doing these specific protocols to address adrenal fatigue?
Ari Whitten: You know, I’ll mention that you and I were on the phone a few days ago and we were talking about this idea of health fads and kind of certain ideas that just takeover in the minds of not only people as a whole, but you know, like the whole population of people interested in natural health or fat loss or, or something of that nature. There are certain ideas that just kind of spread and become eventually known after they’ve spread for so long and they’ve been around for so many years. They just get accepted as truth and nobody realizes that there isn’t actually any real evidence showing that this thing is like actually solid and is grounded in science and is real.
And you know, one example of this is sort of the insulin theory of obesity. That’s a good example of that. That’s been very heavily debunked by obesity researchers like Stephan Guyenet and James Krieger and a number of other scientists, we won’t get into that. But there’s all kinds of other ideas as you know, that are out there that are just kind of fads and become accepted as truths but don’t really have any evidence. And adrenal fatigue is basically one of those. It’s something that has become extraordinarily popular within people in the natural health community and holistic health and functional health and all of that stuff.
Everybody thinks, oh, the adrenals, everybody’s talking about the adrenals. Everybody’s talking about cortisol levels. And specifically in the context of fatigue, that condition of burnout or fatigue or chronic fatigue, stress related exhaustion, it has almost become synonymous in people’s minds with adrenal problems and cortisol problems. And so you complain of like, Oh, I’ve been really stressed and I’m burnt out now and I’m really fatigued. Oh, it’s got to be your adrenals. It’s got to be your cortisol, right?
Well, I get this because I was like, I’m part of the natural health community. I’m part of the functional health community. I’m part of the holistic health community. I’m not here to bash any of that stuff. I’m very much a part of it. I’ve been studying that stuff for 20 years, teaching it for over 10. But I’m also a big advocate of being evidenced based and making sure that the things that we are teaching are actually aligned with the evidence. And if we’ve gone in a bad direction, then we need to look at the evidence and correct ourselves.
So anyway, with that said, basically my background here is that I was actually teaching adrenal fatigue for many, many years. I was a believer in adrenal fatigue. I’d read books on it, I had read hundreds of articles on it. And I was like probably many of the people listening, fully a believer in the whole concept of adrenal fatigue and thought that of course all of this is real. There’s books written on it, there’s hundreds or thousands of articles online written about it. How could all of that be written about something that isn’t actually real and doesn’t have a ton of evidence backing it up?
So then I discovered something interesting which kind of irked me and rubbed me the wrong way, which was that, within conventional medicine, they don’t consider adrenal fatigue to be a real thing at all. They don’t recognize it as a legitimate condition. There are bodies of institutes, for example, the endocrine society, which represents 14,000 endocrinologist, that’s doctors who specialize in hormonal health, like for example, cortisol hormones. And they’ve publicly stated, and this is a quote, “adrenal fatigue is not a real medical condition. There are no scientific facts to support the theory that long term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms”.
So that kind of stuff, when I saw that this condition, which I was a full believer in, was being brushed off as nonsense and pseudoscience by conventional medicine. I actually had an idea, and this is kind of an ironic story, especially given what I’m on this podcast now to talk about, but I want to tell you all sort of the ins and outs of the story. Basically, I had this idea that I was going to go write a book. I was going to call it “The Evidence Based Guide to Adrenal Fatigue”. And my plan was to go on to Pub Med and Google Scholar. Pub Med is basically like Google for scientific research. You can just type in any condition you want and look at all the research on that subject.
And I was going to go there and I was going to browse through, you know, all the hundreds or thousands of studies that had been done on adrenal fatigue and I was going to compile it all into a book and I was going to prove that adrenal fatigue really is legitimate. And I was going to prove it with the science. And I was going to be like: See, conventional medicine, you guys have it wrong. Really the science does support the concept of adrenal fatigue. Okay. And here’s what happened. Day One, I went to pubmed.com and I typed in adrenal fatigue. Take a guess how many studies came up in my search, Robyn?
Robyn: I’m a little wondering if there weren’t any?
Ari Whitten: Good answer. So let me just contrast this, because if you do a search on Pub Med for any medical condition, so, Diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, Hashimoto’s, whatever condition you can possibly think of, even really obscure ones and rare genetic diseases. Type in any of those things and you will get a response, a search result of hundreds if not thousands of studies on every conceivable facet of that condition. You type in adrenal fatigue and you get nothing. Okay, so literally nothing. Type in adrenal fatigue in quotes and look at what comes up. And you will be blown away that there is not a single study that has ever shown on a physiological level that this is a real condition.
Robyn: Okay. So is this like one of those things like from what I can tell, telling people that eating Greens is going to suppress their thyroid is something that got said on the Internet and just got passed along and passed along. And so doctors and rather sophisticated professionals would read it and be like, Oh yeah, I’ve read that before. So it must be true. Is that what happened here?
Ari Whitten: Kind of. It’s a little bit more involved and longer term than that. And you know, basically this comes out of originally Hans Selye’s work. He was a physiologist and a researcher. He did research in the 1930s to 1950s so nearly a hundred years ago was when he was a prominent researcher. And he did research on animals basically showing that if you subject animals to extreme stress, and he was tracking their hormones, so things like, adrenaline and cortisol were the main sort of measures that he was tracking.
Basically when you subjected them to days or weeks of really, really severe chronic stress, like think torture, like think electric shocks and that sort of thing. They get to a point before they actually die, where their hormones decline. So you see sort of this abnormality of hormone levels. The pattern that he found was that they sort of rise first and then they decline before the animals actually die and then they die.
So out of that research, there was another guy, I’m forgetting the guy’s name, but he was prominent in the 70’s and 80’s. He basically extrapolated out of this research that cortisol is the problem in fatigue. And that for people who have chronic fatigue, we just need to fix their cortisol levels. So we can inject them with hydrocortisone or have them take hydrocortisone pills and raise their cortisol levels and that’s the cure for fatigue.
So the idea has actually been around for several decades. And then, I think it was 1999 or maybe 2001 there was a guy named James Wilson who coined the term adrenal fatigue and wrote a book called “21st Century Stress Syndrome”. And said: hey, you know, the reason that we have this epidemic of fatigue is that we have this stress response system in our bodies and it’s primarily the adrenals and they produce this hormone called cortisol that is one of our primary stress response hormones. And it does things like help keep blood sugar levels stable and regulate the release of blood sugar. And does other things like sort of just liberates energy from the body and suppresses inflammation and does a variety of things like that. And it’s part of this stress response system.
So when we have chronic stress, that chronic stress taxes this stress response system and sort of wears it out over time. And then by doing that, once you wear out the adrenals, you get adrenal fatigue and then you get abnormal cortisol levels. You get initially the adrenals are being stressed, they’re producing lots of cortisol, and then over time they get worn out. So they go from this initial, what’s called an alarm reaction, in the way he conceptualized these three phases of adrenal fatigue. You get an initial alarm reaction, cortisol levels go up. Then over time you get what he called the resistance or stage two. And in that stage cortisol levels may still be elevated or maybe in the normal range. And then eventually chronic stress sort of wears out your adrenals and you get stage three true adrenal fatigue or adrenal exhaustion or adrenal burnout. And then you get low cortisol levels and that’s when you really have the symptoms of chronic fatigue.
Okay, and so that’s the theory. It was sort of originally based on Hans Selye’s stuff that started in the 1930s to 1950’s. And then kind of other people toyed with that general idea of the adrenals or the HPA access, the hypothalamus, pituitary, adrenal access, being this sort of critical stress response system. And that with chronic stress it wears out that system and then you get cortisol abnormalities and then that’s the cause, the primary sort of physiological mechanism and cause of fatigue.
So it makes some sense and there’s some legitimacy to it. So the HPA access system and cortisol genuinely are important parts of our physiology and are involved in the stress response. I’m certainly not debating any of that. That is all legitimate. The question is, does the research actually support that adrenal fatigue is a real thing and that cortisol abnormalities or adrenal abnormalities are the primary cause of chronic fatigue or burnout or stress related exhaustion?
And the answer to that is, No. And that’s where the big disconnect is, is that there’s this sort of logical sounding theory that sounds good and sort of seems to make some sense. And it just kind of took hold and spread like wildfire and everybody started preaching it, but nobody actually bothered to really deeply explore the research and check whether the research actually supports that that is the central mechanism of stress related exhaustion or fatigue.
So that’s what I’ve done. So I mentioned before that when you look to the research on adrenal fatigue and you try and look that term up, there’s nothing that comes up. So I was kind of stonewalled. There wasn’t anywhere to go after that happened. So what I figured out, and this was a process that happened over many months, but what I figured out is that there is actually some relevant research to this concept that will allow us to test the theory. What I found is that there are several accepted medical conditions that are pretty much synonymous with the basic idea behind adrenal fatigue.
What they are called, they go by a few different names in the scientific literature. One of them is called, burnout syndrome or clinical burnout. The other one’s called stress-related exhaustion disorder, or sometimes called vital exhaustion. So those are the two main ones and then arguably you have chronic fatigue syndrome which you could potentially lump into this as well. And this is the cool part, there’s research going back over 25 years now, dozens of studies where they have looked, as I said, this idea is not new. Researchers have looked at this specific thing as to whether cortisol and adrenal function abnormalities are responsible or even associated with these symptoms of burnout syndrome, stress related exhaustion disorder. They’ve been doing this research for over 25 years. The studies actually do exist.
So the only difference between burnout syndrome and stress-related exhaustion disorder and adrenal fatigue, they’re basically synonymous in terms of this, the basic idea is chronic stress leads to fatigue. Okay. That part is true. That part is legitimate. The difference is adrenal fatigue goes a step further and it’s not just saying, hey, chronic stress leads to fatigue. It’s saying chronic stress leads to fatigue because of what it does to your adrenals and your cortisol levels. It’s specifying a specific physiological mechanism. Whereas burnout syndrome and stress related exhaustion disorder are not specifying any particular physiological mechanism or any hormone or any particular system of the body. They’re just saying chronic stress leads to these symptoms.
So adrenal fatigue is saying chronic stress is a problem because of what it does to your adrenals and cortisol levels. So I want to clarify that I am not saying if you’ve been told you I have adrenal fatigue and you have chronic fatigue and some of these other symptoms, I’m not saying your symptoms are not real, the symptoms are absolutely real and chronic stress may be behind it. But what I am saying is that trying to fix your fatigue and your symptoms by trying to fix your adrenals and your cortisol levels is very, very misguided.
And here’s why. I told you that all this research exists and researchers have been looking at this for 25 years. What have they actually found? Well if you go, I have a page on my website where I’ve literally compiled, and I’m not exaggerating when I say this, I’ve literally compiled every single study ever done on this subject that has looked at adrenal function and cortisol levels and sometimes HPA access function more broadly, but cortisol levels and adrenal function in the context of all of these different fatigue syndromes. Here’s what they find.
I’ll give you the summary of the data and I have all of this on my site on a page called: “Is adrenal fatigue real”? It’s at theenergyblueprint.com “Is adrenal fatigue real?” And it’s all freely available you don’t have to opt in or anything like that. And I literally have every single study listed out according to date with the names of the study, with the links to the study, with the screenshots of every study that’s ever been done on the subject. Here’s the bottom line of this. There’s 79 studies overall about 20 of them are systematic literature reviews, which is the highest level of evidence. That’s where other researchers look at all of the studies and basically say, here’s what the entire body of evidence says.
Robyn: Yeah, I should pipe in here and say in the three part podcast series that I did, I talked about how I really like to see that kind of evidence because it’s usually reviewing and finding what’s the same or different about dozens or even hundreds, occasionally thousands of studies on a similar subject tells us and then we could put more value on that. And so when he says literature review, I may call it meta-study or meta-analysis, same thing.
Ari Whitten: Yeah. So a meta-analysis is basically the same idea, but just sort of doing the statistical number crunching, and a systematic literature review is sort of a description of all of the studies, but they often go together. So like sometimes you see systematic literature review and meta-analysis all in one. But yeah, that’s the highest level of evidence. And I’ll also add that they’re important because they prevent people from cherry picking the data, which is way too common and is a huge problem. They prevent people from going in and selectively citing the few studies that support their views and their dogmas and their preconceived notions, while ignoring the stuff that doesn’t and leaving that out and making sure that they’re not communicating that information to people.
So what you’re hearing from me now is the entire body of evidence without excluding anything. So I’m not cherry picking. And just to make sure I’ve actually put this in a public place and said, here’s all of the studies that have ever been done, please someone challenge me and show me the holes in my thinking and my conclusion based on this evidence. I’m putting it in a public place, anybody’s free to come tell me, hey, you’re cherry picking and you didn’t cite this study and that study. No, I’m not. And I’m putting it in a public place because I’m willing to prove it.
So here’s what the study says. So there’s 59 individual studies, 15 of them give evidence for lower morning cortisol levels in people with chronic fatigue or burnout or stress related exhaustion. 11 of them give evidence for the opposite finding, higher morning cortisol levels in those people. And then 33 of the 59 studies, more than half of them, which is the vast majority of them, show no differences at all. No significant differences. No detectable differences in cortisol levels or adrenal function between people who do have a stress related exhaustion or clinical burnout or burnout syndrome versus normal healthy people without any symptoms. You cannot tell the difference based on their cortisol levels.
Robyn: Okay. One of the reasons why that’s so interesting is that functional medicine doctors who a lot of our listeners look to cause they’re like, hey, I don’t want the guys who just prescribe chemical drugs. I know the limitations of that model. I want something better. I want something that looks to root cause. I want something that’s going to dig deeper for me and not do harm with the solution. We go to these functional medicine doctors and how pervasive is it to do this cortisol testing. Maybe say a little bit more about the recommendations that are being made based on this cortisol testing, from is it urine? Because you know every year I get a whole panel of like blood, hair, urine and figure out exactly where I am hormonally, cause you know I’m not young. And this has been part of the testing protocol of every functional medicine practitioner I’ve ever been to.
Ari Whitten: Yeah. So it’s interesting, as I said before there are certain ideas that just kind of spread like wildfire and just take hold and become fixated in people’s minds and they think, oh this is the thing. This is super important. I guarantee you like just to be clear for people listening, your doctor that’s doing cortisol levels tests on you has never looked at the research that I’m sharing with you and that I’m talking to you about right now.
And I’m not saying this to exaggerate. I’m not saying this to brag. I’m saying this because it’s just a fact. I have done the most comprehensive review of the science on this topic that anyone has ever done. And I’ve actually posted it all publicly available with all the screenshots and actual quotes of the studies. So, the unfortunate reality is that most of these physicians and functional medicine docs who are doing these cortisol tests haven’t even looked at a fraction of the literature that I’m actually citing here. And so they’re all operating under this presumption that, oh, you know, adrenal problems and cortisol problems and HPA access problems, that’s obviously the central thing that’s going on in chronic fatigue. But they just haven’t actually looked at the research. So they’re doing these tests on cortisol based on a theory that hasn’t actually been validated but is widely accepted as true. And actually the research shows that it’s not true.
You know, there’s other nuances here that we can get get into. One of the other things that I’m about to publish actually is that I just did a deep dive on the literature on two other things in addition to the link between cortisol levels and these fatigue syndromes. I looked at cortisol levels and their relationship with chronic stress more broadly. And it’s a really cool thing to dig into because you can find all sorts of different chronic stressors, anything that you can sort of dream up.
You can find chronic stress from unemployment, you can find chronic stress from work overload, the exact opposite of unemployment stress. You can find it from people who are in work and being overworked. You can find it from people who have relationship stress and people who are fighting with their spouses and people who have financial stress and every conceivable type of stress that you can imagine. And then you can also even look at sort of the more broadly, things like, for example, cigarette smoking or drinking alcohol as quote unquote stressors. You can also look at the research between those things and cortisol. And what I found when I went into that literature, overwhelmingly, okay, like I’m talking about 98% of the time, the research generally shows slightly elevated levels of cortisol in those people. Slightly elevated, not lower cortisol levels, not adrenal exhaustion, slightly elevated levels of cortisol. And that’s the consistent finding.
Then you look at this other body of research that I dug into is the relationship of cortisol levels in all sorts of chronic diseases, so you can look at diabetes, you can look at obesity, you can look at heart disease, you can look at cancer, you can look at neurological diseases, Alzheimer’s, Parkinson’s, Hashimoto’s, hypothyroidism, that’s one that people often say, you know, in the functional medicine community who are, you know, talking about the thyroid. They say, Oh, you know, if you have hypothyroidism it’s very likely you also have adrenal fatigue. Well, guess what? If you look at all of that literature, what you find very consistently is slightly elevated cortisol levels. Basically no indication of lower cortisol levels in any degree of either chronic stress or chronic disease, overt chronic disease that people have maybe had for years or decades. You still don’t see any real indication of adrenal exhaustion and low cortisol levels.
So this whole model of these three phases of adrenal fatigue that are sort of predictable phases of your adrenal function and your cortisol levels based on how much chronic stress you’ve had and how long you’ve had it. It’s total nonsense. And none of those three phases of adrenal fatigue have science to back them up. It’s a theory that someone made up that spread and there is zero science to back it up. The science actually overtly contradicts the idea that there is any predictable phase three adrenal exhaustion. You know, basically people became obsessed with cortisol and it’s just really misguided. You know, cortisol is one of many dozens of things in the body, many dozens of hormones and other bio-chemicals and neurotransmitters and systems in the body and other factors that plays a role in things like energy levels and inflammation. But it’s not the central cause of disease or fatigue.
Robyn: I believe you and I know you to be a researcher who just goes to the mat for things. You’re not doing it because you’re going to make money selling a book. You do it cause you’re deeply curious person. So what does this mean for the average patient or even the average practitioner answer either one or both in terms of guiding treatment. How would, for instance, a patient who goes in and we know our functional medicine doctor is going to start talking to us about cortisol and want to do, I think it’s saliva testing actually, and tell us about our early morning cortisol versus our late at night cortisol. And how should treatment be guided differently based on the fact that we’ve got maybe a chicken and egg problem here or a correlation does not imply causation issue here. What do we do with this information?
Ari Whitten: Yeah. Well, so there’s two facets of this answer. One facet is let’s address first, you know, the people who are listening to this and who are saying, I actually had low morning cortisol levels on my test and my doctor told me I have adrenal fatigue and the test showed that I really did have low morning cortisol levels. So how do you explain that? And the answer is I actually did a deep dive on that literature too. I have a big article coming out very soon on that topic, but it’s basically, you know what I just told you is that chronic stress is not a reliable cause of low cortisol levels. Chronic disease, overt chronic disease of various kinds is not a reliable cause of low cortisol levels and fatigue, stress-related exhaustion is also not a reliable cause of low morning cortisol levels.
So here’s what’s going on. First of all, let’s distinguish between real actual low cortisol levels versus what is the most common finding in the people who think they have low morning cortisol levels, they actually don’t. What they have is a flattened diurnal curve of cortisol. They have lowered morning cortisol levels and higher evening cortisol levels and they usually have perfectly normal 24 hour output of cortisol. So if you measure it in terms of urinary metabolites of cortisol over the course of 24 hours, what you almost always find, even in people who had low morning cortisol levels, is that their total 24 hour output of cortisol is perfectly normal. Okay. And even perfectly optimal or even high.
So there’s research from a lab called “Precision Analytical” that took samples from 2000 people who had low morning salivary cortisol levels and then they did 24 hour urinary analysis of their cortisol. Only 15% of those hundred percent of people who had low salivary morning cortisol levels, only 15% actually had low cortisol levels in a 24 hour measurement. The other 85% had either normal or high cortisol levels, total 24 hour production of cortisol levels. So that tells you something very interesting. It tells you that there is no actual adrenal fatigue or adrenal burnout or adrenal exhaustion. The adrenals are absolutely still producing enough cortisol over the course of 24 hours. They’re just not doing it at the right times over the course of the 24 hours. There’s too little in the morning and usually oftentimes too much in the evening.
So what’s going on there? Well, what I did was a deep dive into literature on the causes of a flattened diurnal curve in cortisol. It’s not chronic stress. The adrenal fatigue theory is wrong. What is it? What does the literature actually show is a real cause of that situation? The biggest one is circadian rhythm disruption. Circadian Rhythm is our biological rhythm, 24 hour clock ,in our brains that regulates lots and lots of neurotransmitters and hormones and systems of the body. Cortisol is just one of many that is regulated by that.
And basically if you disrupt circadian rhythm as our modern world does, because we live in an artificially lit world, we’re not spending time outdoors in the sunlight, we’re not getting morning sun, we’re not doing the other things that support our circadian rhythm, like meal timing, movement timing, and there are other layers to the story as well. And we’re getting too much artificial light at night, which sends the signal to our brain: it’s daytime, the time to be awake, alert, active, energetic. And ultimately what happens as a result of that is your circadian rhythm gets disrupted. Once your circadian rhythm gets disrupted, the timing of lots of different neurotransmitters and hormones gets shifted.
One of the effects of it is a flattened diurnal curve of cortisol, too little cortisol in the morning, too much in the evening. Okay, so circadian rhythm disruption is extremely common in today’s world and that is actually the primary cause of why somebody has low morning cortisol levels. It’s not chronic stress wearing out your adrenal function, your adrenals are functioning perfectly fine. You don’t need to go on adrenal support supplements and you don’t need to go on hydrocortisone what you need to do most of the time, and I’m generalizing here, this is the most common cause, it’s not always the cause, but the most common cause is circadian rhythm disruption. So you need to optimize your circadian rhythm.
Secondly, sleep which is very much related to that. Sleep disruption, if you have poor sleep, poor sleep efficiency, if you have sleep disorders, sleep apnea, sleep movement disorders, upper airway restriction, which is also extremely common. By the way, sleep disorders like sleep apnea are found in over 50% of people with chronic fatigue syndrome. Or if you just are a regular person and you are a workaholic and you only sleep five hours or six hours every night and you’re chronically sleep deprived by an hour or two or three, that in itself will cause low morning cortisol levels.
Another big one related to this is chronotype. Okay. Chronotype is whether you are more of a night owl or a morning person. And what has happened as a result of humans shifting out of our sort of traditional ways of life and moving into indoor environments and artificially lit environments and especially since the rise of electronics, computers, iPads, cell phones, TVs, indoor lighting, all of that stuff. Basically what happens when we have all those lights blaring into our eyes in the evening after the sun goes down, we are phase shifting our circadian rhythm.
So what that means is the circadian rhythm was supposed to start sort of winding down into rest and sleep mode after the sun goes down. And we’re supposed to not have any blue wave lengths of light entering our eyes and feeding back into our brain and into our circadian clock after that happens. The only light sources that were available would be candlelight and firelight and things like that, which don’t have significant quantities of blue light, don’t feed into this circadian pathway in the brain. And so now we have all of that light blaring into our brains and shifting our circadian clock a few hours later. In other words, it shifts us all, the modern world shifts us all into more of a night owl rhythm.
Well, here’s the interesting part and I want to emphasize this just for contrast, but again, if you look to the research on chronic stress, you do not find any reliable association between chronic stress causing low cortisol. If you look to the research on chronotype and cortisol levels, you find a huge association. So you find a very direct link. And just for emphasis, let me just emphasize, you can take a group of people, organize them according to whether they are morning people or night people and measure their morning cortisol levels. One more point, these are people who are all perfectly healthy, no chronic stress, no symptoms, no disease. Perfectly healthy people, some of them are morning people, some of them are night people.
You measure their morning cortisol levels. You will find huge discrepancies between their morning cortisol levels, the people who are night owls have low morning cortisol levels and a flattened diurnal curve of cortisol. It is to the point, even in these normal healthy people without any symptoms. Their cortisol levels are to the point that if those people went to a practitioner, like a functional medicine practitioner who believes in adrenal fatigue, they would get diagnosed with adrenal fatigue even though they’re perfectly healthy and have no symptoms just because that’s the morning cortisol level of a person who is a night owl. In other words, the circadian clock shifts the timing and the release and the way that cortisol is released during the morning in such a way that has nothing to do with disturbed adrenal function or adrenals that are incapable of producing enough cortisol. It’s just that the body regulates morning cortisol release in a different way in people with either circadian rhythm disruption or people who are night owls.
There are several other causes. There are other, you know, sort of potential causes of things that can interfere. There’s some toxins that can potentially interfere with cortisol synthesis pathways but those are the main ones. I’ll mention two other factors that are significant. One is past trauma. So if you have like PTSD or you have childhood trauma, that is genuinely something associated with low morning cortisol levels and a flattened diurnal curve of cortisol. Again, it is not a sign of adrenal fatigue. It is not a sign of your adrenals having any problem that need to be fixed. It is that in people who have past trauma or childhood trauma or post-traumatic stress disorder, their stress response pathways and hormones get regulated, get shifted to a new way of regulation. And that’s just how the body is sort of regulating at this new set point. It’s not that your adrenals need fixing. So if you wanted to fix anything in that scenario, you’d want to work on addressing the past trauma.
And then the last potential thing that I’ll mention is chronic inflammation and oxidative stress and infections. And if it’s really severe chronic inflammation and chronic infections or chronic mold exposure and things like that, those can also potentially depress cortisol levels because cortisol is an anti-inflammatory hormone. You know, it’s often thought of as sort of bad thing. It’s a stress hormone and we’ve got to lower cortisol levels and all this sort of stuff. It gets a really bad rap, but cortisol is actually very important. It does a lot of vital roles. And one of the vital roles that it does is it’s an important anti-inflammatory compound.
But when you have a scenario where you have chronic inflammation or you have chronic toxin exposure like mold toxins or infections or, you know, just eating a terrible diet, for example, an inflammatory diet, the body prioritizes the immune and inflammatory activation in order to combat the toxins or the infection or whatever’s going on chronically there and cortisol opposes the body’s ability to fight that. So there’s this sort of tug of war between the body’s desire to fight these toxins properly and cortisol being activated. And so when that tug of war happens chronically and severely enough, you can potentially get low morning cortisol levels from something like that as well, or low cortisol levels in general.
There’s one interesting study on people with Myalgic encephalomyelitis or chronic fatigue syndrome and looking at specifically whether low cortisol is a cause or a consequence of the disorder. And they concluded that low cortisol levels when it does exist in the people who actually do have it, it’s a consequence of other things. It’s a consequence of circadian rhythm disruption, sleep disruption. It’s a consequence of being a night owl chronotype. It’s a consequence of post-traumatic stress. It’s a consequence of chronic inflammation.
So those are the things that actually do cause low morning cortisol levels or a flattened diurnal curve as opposed to this adrenal fatigue idea that it’s just chronic stress sort of wearing out your adrenals. That’s total nonsense and not supported by the evidence. There are a few specific things like past traumas, Circadian Rhythm Disruption, and the other couple of things I mentioned. If you want to actually fix your cortisol levels, those would be the things to address rather than trying to take supplements to fix your adrenals or to take hydrocortisone to boost your cortisol levels, that’s pseudoscience.
Robyn: Well, not only is this really interesting, but I also think it’s really useful and hopeful because the things that you’ve said do link to dysfunction are things I can control. Not necessarily everything you said, you know, maybe infections and oxidative stress are a little bit trickier and more complex mechanisms involved. But you know, when you’re saying basically that if I have a higher stress life, that’s a lot less linked to my cortisol levels or the HPA access health, then things like our blue light exposure, I can control that. I can control how much blue light exposure I get.
When you say, you know, falling my chronotype being aware of my own circadian rhythm. I mean we all know there’s morning people and night people. And we can all without even knowing anything about what your and my mutual colleague Michael Bruce has talked about on my show before, the chronotypes of when we’re supposed to sleep. And we don’t know exactly why some people are morning people and night people, but we know which one we are. I know that I wake up in the morning and my mind is as sharp as it will ever be and I didn’t have the awareness when I was married for 20 years to say, hey, after 9:00 PM would you please not bring up any controversial or potential for conflict subjects because I’m just not my best.
But now I am. And my boyfriend knows very well, Oh, it’s 9:30. Don’t be talking about that. I’ll shut it down. I’ll say, I will talk to you about this in the morning. It’d be going too far to say I couldn’t put a sentence together, but I’m just not my best at night and I really want to sleep rather than do other things. And so it helps me reorganize my relationships, reorganize when I do my work. And I can control when I go to bed and when I get up. Those are easier things to control than to say, I will have no stress in my life. I will do nothing too hard that doesn’t stress me out. So…
Ari Whitten: I don’t want this to get lost. This is an important point. I am not saying that you should still try to fix your fatigue problems by trying to fix your adrenals and your cortisol levels. Because going back to that original research that I mentioned what I am saying is that in the vast majority of the people with stress related exhaustion and chronic fatigue, they have perfectly normal adrenal function and cortisol levels. So we talked all about, we got kinda hyper-focused on debunking this whole adrenal fatigue stuff. But I want to just emphasize that, you know, someone asked me in an interview I did recently actually with JJ Virgin, she said, Okay, so if it’s not the adrenals then what could it possibly be? You know, as if the adrenals and cortisol levels are the only thing that affect energy levels.
And I kind of chuckled because there are dozens of other factors and other systems of the body that affect our energy levels. There are neurotransmitters in the brain. Gut health affects it. Toxins affect it, which is a big thing that you focus on Robyn. Our mitochondrial function affects it. There are so many layers to the story of things that you can optimize to increase your energy levels that have nothing to do with your adrenals or your cortisol levels. And I just wanted to emphasize that to make sure that it’s clear to people so that they’re not still in this whole adrenal fatigue model and thinking that the path to more energy is to fix their adrenals and their cortisol levels.
Robyn: I appreciate that. So I want to just point you to where you can learn more from Ari Whitten because this is just some of his very best work that I like a lot. You can tell that he knows a lot about energy and he doesn’t just accept the current fad of the day and what every functional medicine doctor is doing this year. He goes deeper than that. And so at greensmoothiegirl.com/energyblueprint is Ari’s free video masterclass. I have watched each one of the videos in this free master class multiple times because it’s just so good.
Like one of them, for instance, one of the videos in this free video masterclass really sort of re-instructed me about coffee. And just spoiler alert, Ari doesn’t take a hard line about very many things, including coffee. And he says, Hey, there’s plenty of data that there are health benefits to coffee. However, how you’re drinking it, or you know, the frequency, the amount like that might be an issue. Let’s, let’s take a look at that. So even if you’re just curious about the two thirds of us who drink coffee, even if you’re curious about that, for sure go checkout Ari’s Energy Blueprint free video masterclass at greensmoothiegirl.com/energyblueprint.
And Ari, thank you so much for being so generous with the research that you’ve done. I know that you’re really on a mission to help turn things around for people who suffer from chronic fatigue and fibromyalgia and all these energy deficit disorders. So thanks so much for being on the show today.
Ari Whitten: Yeah, you’re welcome.