The Marathon

The Portland Marathon was this weekend. I went to cheer on a couple of friends who were running it and felt inspired and awestruck by their determination and will to complete the race. It is quite an accomplishment to train for and participate in this type of endurance activity. Some of us have the capacity for it and some of us don’t. While it can be thrilling and motivating, this kind of extreme output of energy can also be detrimental for certain individuals.

I have heard more than one person/patient tell me “my energy has not been the same since I ran the marathon” or “my ability to work out has greatly diminished since I trained for the race” or “I don’t seem to recover like I used to from bouts of exercise”. For those individuals, the marathon might have been an exhilarating experience, but one that left them with little reserve. These are classic cases of adrenal burnout. When you are training for something like this, you are exposing your body and adrenal glands to a steady supply of stress. If you are at all adrenally fatigued, you pump out just enough cortisol to keep on going. Once the stressor (in this case training for the marathon) is taken away, the adrenal glands finally have a chance to chill out, and the individual crashes; the adrenal gland function plummets and the symptoms of adrenal fatigue emerge.

Even if you haven’t seen this in a marathon runner before, you probably have seen it in your colleague who gets sick every time he takes a vacation, or the student who gets a URI on every school break. Once the perceived stressor is eliminated the cortisol output is diminished. It is postulated that this is mediated by a decreased response from the hypothalamus in the HPA axis or perhaps a result of other hormone mediated stimuli to the HPA axis. The exact cause is still being explored. What we do know is that the way an individual responds to stress depends on many things: genetics, lifestyle, neonatal environment, previous experiences etc.

Clinically, we see these different responses in the many faces of adrenal fatigue. Some people might be pushing themselves to constantly do more and work harder, and some might be sleeping more than usual and retreating from normal activities. Individuals will have their own responses, but it’s our job as health care providers to help them when they present to us during a crash.

It’s our job to remember and remind the patient that when one is suffering from adrenal fatigue, pushing to work out more, stay up later, and work harder is not the way to get better. These people need to nourish their bodies and build their stores back up. Good sleep habits, proper nutrition for the adrenal gland, healthy diet, decrease stress and gentle exercise are what is needed to heal adrenal fatigue. That takes time and will and determination…. in fact, It’s a marathon of its own kind!

Dr Elise Schroeder