Adrenal fatigue

 

CASE STUDY: Adrenal fatigue

CLIENT: 34-year-old female

INITIAL PRESENTATION:

The client, a generally healthy individual who six months previously had a baby, presents with chronic fatigue and sleep disturbances, worsened since childbirth.  She struggles with deep sleep and waking up multiple times during the night, leaving her feeling drained and unproductive.

Her high-stress job, combined with the demands of new motherhood, has left her feeling overwhelmed and exhausted, with limited physical activity and irregular eating habits.

She consumes 3-4 cups of coffee daily to combat fatigue and occasionally takes Panadol for headaches.

Vital signs are stable, and a physical exam reveals mild neck and shoulder tension, probably due to stress.

Naturopathic assessment:

34-year-old woman presenting with chronic fatigue, high stress and headaches likely caused by poor nutritional intake, sleep onset and maintenance concerns, and HPA (hypothalamic-pituitary-adrenal) dysfunction.  These were exacerbated by her job pressures and newborn baby.

Key factors considered:

• High stress: The clients demanding job, combined with the pressures of caring for a newborn, are overwhelming her nervous system and disrupting her natural circadian rhythm.
• Sleep disruption: Difficulty falling and staying asleep, along with night-waking, is likely due to elevated cortisol levels, her baby waking her, caffeine and low nutritional intake.
• Irregular meals and high caffeine intake: Contributing to her energy crashes and poor sleep quality.
• Lack of self-care:  The client’s responsibilities make it hard to make time for selfcare, affecting her stress levels and overall well-being.

 

HERBAL MEDICINE

• Ashwagandha (Withania somnifera): An adaptogen that helps regulate the adrenal glands and reduce stress.  It’s especially helpful for individuals experiencing burnout and fatigue.
• Rhodiola (Rhodiola rosea): Known for its ability to combat fatigue, improve mental clarity, and enhance physical endurance.  Rhodiola helps balance cortisol levels, supporting the body’s response to stress.
• Passionflower (Passiflora incarnata): An herb for calming the nervous system and improving sleep quality.  Passionflower helps reduce anxiety and promotes deeper sleep.
• Liquorice (Glycyrrhiza glabra): A powerful adaptogenic herb known for its ability to support adrenal health and boost energy levels.  Liquorice helps balance cortisol, the body’s stress hormone, and can aid in reducing the effects of chronic stress.

Herbal formula:

Withania (Withania somnifera)             80 mL
Rhodiola (Rhodiola rosea)                   50 mL
Passionflower (Passiflora incarnata)    50 mL
Liquorice (Glycyrrhiza glabra)              20 mL

                                                           200mL

 

NUTRITIONAL, SUPPLEMENTAL & LIFESTYLE CHANGES:

Nutrition modifications:

• Eat three meals a day: Aim to eat at least three balanced meals per day to stabilise blood sugar levels and prevent energy dips.  Meals should include lean proteins, complex carbohydrates, and healthy fats to support adrenal health and overall energy.
• Husband preps her meals: The client should lean on her husband for greater support during this time asking him to prep her meals as she used to do for him.
• Reduce caffeine intake: Gradually cut down on coffee and replace it with decaf coffee or caffeine-free herbal teas such as chamomile, lemon balm, or liquorice, which promote relaxation.  Limit caffeine to one- two cups before mid-day.
• Eat more magnesium-rich foods: Magnesium helps support relaxation and quality sleep.  Foods including spinach, almonds, bananas, and pumpkin seeds should be added to her diet.
• Hydration: The client is recommended to drink plenty of water throughout the day, aiming for at least 2 Liters daily.  Avoid drinking excessive amounts of fluids close to bedtime to minimise night-time trips to the bathroom.

Supplements:

• Activated B vitamin complex: These are critical for adrenal function, stress response, and energy production.  B vitamins help to reduce the impact of stress on the body and support mental clarity.

• Vitamin C: An essential nutrient for adrenal support, especially during times of stress.

• L-theanine: Helps promote relaxation and reduce stress by increasing calming brain chemicals like GABA, dopamine, and serotonin.  It also supports better sleep by creating a calmer mind, aiding in quicker sleep onset and deeper rest without daytime drowsiness.

 

Lifestyle Recommendations:

• Mindfulness and relaxation techniques: Teach the client relaxation techniques such as meditation, diaphragmatic breathing exercises she can do throughout her day to lower cortisol and help her unwind.
• Gentle movement: Encourage yoga or walking to release built-up stress, improve circulation, and enhance sleep quality.  20-30 minutes of movement during her lunch break will help balance cortisol and support overall energy levels.
• Sleep hygiene: The client is encouraged to create a calming nighttime routine that includes the whole family.  Bath time with the baby with some calming music and dim lighting, decreasing bright lights and screens as much as possible and putting the baby and herself in bed at the same time each night. 
• Delegate and set boundaries: The client is encouraged to explore ways to reduce work-related stress by delegating tasks and setting boundaries.

 

FOLLOW-UP:

After 4 weeks of following the wellness plan, the client reports a significant reduction in her fatigue levels and a noticeable improvement in her sleep.  The client finds it easier to fall asleep and stay asleep at night with less waking during the night.

Although stress from her high-pressure role remains, her energy is more stable throughout the day, and her ability to focus has improved.

Her husband has also been stepping up and helping her more with the baby and meals, taking the extra stress off her.  The combination of adaptogenic herbs, magnesium, and relaxation practices has helped reduce her anxiety and stress response.

The wellness plan will be maintained, with continued focus on nutrition, stress management, and sleep hygiene, ensuring sustained improvement in her adrenal health and overall vitality.