On my website I talk a great deal about “compromised adrenal glands”, and how many people with thyroid and autoimmune thyroid conditions have problems with their adrenal glands, which can be directly causing or contributing to their condition. And this is true, as most people I consult with do have adrenal issues which need to be addressed in order to restore their health back to normal. However, when someone is dealing with fatigue, one can’t assume that this is always due to the adrenal glands, as it could also be due to anemia. Of course other factors can also cause fatigue, but in this article I will be focusing on adrenal fatigue and iron deficiency anemia.
So when I consult with a patient who is experiencing fatigue, I will almost always recommend an Adrenal Stress Index test. This of course isn’t the only reason why I recommend adrenal testing, but if someone is experiencing fatigue then we definitely need to look at the adrenal glands. When the person is experiencing fatigue I usually look for either low cortisol levels, and/or low DHEA levels. However, a person with fatigue can also have high cortisol levels, as if they are experiencing a lot of stress then the adrenal glands will usually secrete an excessive amount of cortisol as an adaptive mechanism to the stress, and then over the months and years the adrenals will weaken, which will lead to low cortisol levels.
If the person has low cortisol levels, then they will need to receive the appropriate adrenal support. This may be licorice, but if the person has high blood pressure then liquid rehmannia would be the better option. Eleuthero is also a good herb to use for adrenal support, and especially if a person is experiencing chronic stress. These herbs can also help to raise low DHEA levels, although if the DHEA is really low then bioidentical DHEA may be needed for a short period of time. For menopausal women, Tribulus can also help to raise low DHEA levels.
Detecting and Addressing Anemia
If someone is experiencing fatigue but has normal cortisol and DHEA levels, then anemia should be suspected. Once again, sometimes the adrenal glands are compromised, but are still able to adapt and secrete a sufficient amount of these hormones for a short period of time. So just as is the case with thyroid blood tests, one can’t assume that normal cortisol and/or DHEA levels means there are no problems with the adrenals. Plus, there is no rule which states that someone can’t have multiple problems, and so even if someone has low cortisol levels and/or DHEA levels, it’s a good idea to make sure they have sufficient iron and ferritin levels. Fortunately, many of my patients have recent labs from another doctor which will show the iron and ferritin levels. However, one can’t always rely on the blood tests alone. A hair mineral analysis will also reveal the iron levels. But sometimes low iron levels on this test means that iron is biounavailable.
So there are times when an iron deficiency is obvious, but other times it isn’t obvious. When an iron deficiency is detected then the short term solution is usually to supplement with iron. However, one also needs to look at the relationship of the other minerals when looking at an iron deficiency. In other words, sometimes to correct an iron deficiency one needs to balance out the other minerals. And of course one’s diet is very important as well, as some people don’t eat enough iron rich foods. The best food sources that are high in iron include meat, poultry, and fish. Eggs, leafy vegetables, lentils, and sunflower and pumpkin seeds are other food sources.
Also, keep in mind that a copper deficiency can also lead to fatigue. So someone can have strong adrenal glands, normal iron levels, but have a deficiency in copper which is causing their fatigue. As I already mentioned, it’s not unusual for people to have multiple problems. So even if someone consults with you who has a known iron deficiency problem, this of course doesn’t’ mean they also can’t have compromised adrenal glands. This is why it’s important to consult with a doctor who looks at the entire picture, as many medical doctors would just assume a person’s fatigue is due to anemia, but won’t even bother to evaluate the adrenal glands.
Why Is Iron Deficiency Anemia So Common?
In past articles and blog posts I’ve discussed in detail why many people have weak adrenal glands, and so I’m not going to talk about this here. But why do many people have an iron deficiency? Well, an iron deficiency is more common in cycling women, which shouldn’t be a surprise, as because they menstruate they require more iron than men, or women who are in menopause. But when menstruation is heavier or longer than it should be then this obviously can lead to an iron deficiency. In addition, certain medications or diseases can make it difficult to absorb iron. There are also certain herbs which can interfere with iron absorption, which is another reason why you need to be careful about what you take on your own.
One’s diet can of course lead to an iron deficiency. This is more common in vegetarians, but can also occur in people who eat meat. Those who are vegetarians need to make sure they eat some foods rich in iron on a daily basis.
In summary, there can be numerous reasons behind one’s fatigue. As a result, one can’t assume that fatigue is just due to compromised adrenal glands and/or an iron deficiency. With that being said, anyone who is experiencing fatigue should have their adrenal glands evaluated, and definitely should have their iron and ferritin levels checked. But the doctor should perform a complete evaluation, as there can be othe factors I haven’t discussed in this article which are causing or contributing to the person’s fatigue.