HILDA LABRADA GORE: Many of us walk around feeling drained, tired and depleted. What would it look like if we had the energy we longed for? No more afternoon crashes? No more brain fog? Kristen Files, a functional nutritional therapy practitioner and master restorative wellness practitioner, discusses adrenal fatigue—what leads to it, some of its symptoms and how to address it. She also tells her own story and describes the shifts she noticed as she addressed the root causes of adrenal fatigue. Finally, she offers ideas for how to help heal and regulate one’s physiology.
Kristen, I’ve heard you say that you were “born exhausted.” Tell me about that.
KRISTEN FILES: I was! I define my life in three eras: “exhausted,” “surviving exhausted” and now “surpassing exhausted.” As a kid, I would get up in the morning for school and brush my teeth and then nap, eat and then nap, pack my bag and then nap, and sleep all the way to school—and sometimes I would even fall asleep during my tests in school. School was so exhausting, I had to come home and nap. That’s how my life was for about fifteen years.
HG: Did your parents find anything unusual about this?
KF: They did, but when they took me to doctors, there were no answers for me. When I was younger, I went to a gastrointestinal (GI) doctor, who gave me things like the fiber supplement Metamucil. Doctors never counseled my family on how to eat properly or about things that might be detrimental to my health, or food allergies.
When I hit the magical teenage years, it was antidepressants. They would try one after another. Nothing worked because that wasn’t the problem for me. When I was in my early twenties, I even had a doctor recommend the sedative Ambien to me. I thought that was funny; my complaint was that I couldn’t wake up, and so she gives me some sleeping medicine! That’s when I was done with the conventional model.
HG: When did you realize that your state of exhaustion was related to the adrenals?
KF: It was after my childbearing years. I have four children, and I had them in my twenties and thirties. When I had my fourth child, a friend recommended a natural practitioner. They figured out that I had a systemic candida infection. Once I cleared that up, I would experience “two steps forward, one step back,” still digging deeper. I would call myself “half a person.” I never felt like a full person until I stumbled upon the adrenal issue and started tackling that. That made a huge difference in my health.
HG: I’ve heard the term “adrenal fatigue” or we hear people say, “I have an issue with my adrenals,” but I’m not sure we all understand what it means. What are our adrenal glands?
KF: It’s interesting because “adrenal fatigue” is a term that conventional doctors will laugh at. It’s not localized to your adrenal glands, and they don’t wear out. It’s like the term “leaky gut”—it’s a layperson’s term, and a doctor will laugh at you if you use it—but if you go to them and say, “I have intestinal permeability,” then they’ll take you seriously. Adrenal fatigue is very similar. It’s not your adrenals wearing out even though it’s actually a great term. I like it because it describes how you feel—but a doctor won’t take you seriously. “HPA axis dysregulation” is a term that a progressive doctor may acknowledge.
Your adrenal glands are part of the endocrine system and govern your fight-or-flight response. The adrenals are two little triangular organs that sit just on top of your kidneys. If you think of “adrenal,” that tells you that they’re next to your kidneys (renal). They have different sections or layers in them. The outer layer produces your mineralocorticoids, which regulate things like sodium, electrolytes and blood pressure. You also have your glucocorticoids, which are involved in things like blood sugar regulation. You have cortisol, for which the adrenal glands are best known, and you have your sex hormones (DHEA, estrogen and testosterone). Those are all regulated by the outer layer.
In addition, you have the inner layer, the medulla, which regulates your adrenaline response. That’s the thing we refer to when we talk about someone lifting the proverbial car off the baby.
HG: Let’s go back to the HPA axis. What does that stand for?
KF: “H” is for the hypothalamus, “P” is the pituitary and “A” is the adrenal glands.¹ You have several different axes throughout the body. In addition to the HPA axis, you have the HPT (hypothalamus-pituitary-thyroid) and the HPG (hypothalamus-pituitary-gonads) axes. You have to look at what is common across all of them—and that’s the hypothalamus and the pituitary. They are responsible for the regulation or the output of the adrenal glands. The hypothalamus is like the watchman or the thermostat of the body—monitoring what is going on. If there is a situation where there’s an alarm, then it will signal the pituitary to produce hormones to signal the adrenal glands to fire. That’s their normal function, and it can be upregulated or downregulated based on the situation.
That normal function can be bypassed whenever you’re in a fight-or-flight situation. It doesn’t even have to be an actual fight-or-flight; it could be something that you perceive as fight-or-flight. It could be actual trauma—a situation of abuse, or something that puts you in extreme fear—but it could also be something that’s perceived as trauma. The body’s treating these things the same way. When that happens, it signals the amygdala, which is like our emotional center. That bypasses normal function and goes straight to the adrenal glands and causes the adrenal glands to fire. When that happens often and consistently, then your hypothalamus and pituitary can downregulate. That’s where HPA axis dysregulation comes from.
HG: A lot of us are under chronic stress. It doesn’t need to be someone hitting me over the head with a baseball bat. It could be something like a boss who is extremely demanding; every time I go into the office, my body automatically responds as if I were being chased by a saber-tooth tiger. This will naturally cause dysfunction in the HPA axis or in the adrenals because it’s like they’re constantly turned on. Is that right?
KF: That’s a good synopsis of it. There are lots of stressful situations. The boss is a good example, but it can even be something like driving in traffic or the demanding schedules many of us have for our kids. There are a lot of day-to-day situations that can cause this to be dysregulated.
HG: How is it that you were born with this dysregulation, if your body wasn’t under any particular stress or trauma?
KF: I don’t know that it was necessarily adrenal dysregulation straight from the get-go, but if you think of Pottenger’s cats, we are passing down our dysfunction or environment to our children. (For those who are not familiar with Pottenger’s cats, it’s worth watching a short fifteen-minute video on YouTube.²) If my mother, who is extremely dysregulated and always in fight-or-flight and stressed out, experienced a lot of unresolved traumas when she was young, she’s passing her deficiency down to me. It takes less for me to be in that fight-or-flight state because I was already born deficient. I also had a lot of gut health problems, which I had to work on as well.
It is more commonplace for people to recognize the gut health piece, but for me, it wasn’t the only piece. If you are in this fight-or-flight or what we call “sympathetic” state all the time, then you’re not going to digest your food. If you’re running from a lion, you don’t need to digest a hamburger. Digestion is put on the back burner when you’re in this stress state. So, which is the root cause? Is it your gut health, or is it your adrenal regulation? You have to work on both of them.
HG: I can’t help but think that this is the world we’re in now. I know a lot of young people who are even losing their hair. Again, the hair is not important to the body as it’s trying to survive. The body wants to make the most of its energy, so it’s not going to put it into keeping the hair luscious, shiny and full when it feels like it is being chased by a tiger or lion. Are most people now in a state of adrenal dysfunction?
KF: It’s becoming more commonplace certainly, especially because we have so many things coming at us. We have environmental toxins, EMFs and non-native electricity. We’re born more deficient, and then we have terrible food. Our soil’s not up to snuff. We also have the last few years of chaos, so that puts us in dysregulation. Some people are able to handle it better than others. I like the “thermostat” comparison. If you start out with a rundown system, you’re going to have to address it or replace it sooner. If you’re constantly taking care of it and doing the maintenance, then maybe you won’t have as many issues.
HG: I want to talk about the symptoms. We’ve already talked about how people might have issues with their gut, or their hair might fall out. What are some ways that we can easily detect what’s happening with our HPA axis or our adrenals?
KF: The hallmark symptoms of adrenal dysfunction are exhaustion and feeling overwhelmed. If you are constantly feeling exhausted, even if you’re eating a great diet—if you’re doing all the right things and you still feel that inside—that’s a sign to dig deeper into the adrenal dysfunction. But it can be all kinds of things. Vision issues are a big deal. Having to wear sunglasses a lot or being sensitive to bright light is an adrenal issue. If you look back at pictures in the 1970s of people on the beach, nobody had sunglasses on. That’s a modern-day issue. Another issue is dizziness, especially when you’re going from sitting to standing. Alignment issues and things like plantar fasciitis or shin splints are related to adrenal dysregulation. Other signs include cravings (especially if you have a craving for salt), constant sicknesses and any sexual dysfunction. Fertility is a big issue for people. There’s a lot of overlap there.
HG: You have three easy categories for people to understand themselves. Can you give us that framework?
KF: There’s some debate about this framework, and some functional nutritionists want to toss it all out the window, but a lot of it is still valid. The concepts were developed by Hans Selye, the “father of stress research,”³ in the 1900s. I believe he was a contemporary of Dr. Price.
The first category is “wired.” This is a person who is “go, go, go,” always wanting to get things done and active all the time but prone to anxiety or insomnia. They can’t turn it off at night. They have weight gain, heart palpitations and ADD [attention-deficit disorder] symptoms—they can’t focus on one thing at the time. I have a little saying for each of these categories. This is the slogan for the wired types: “rosé all day.” I especially see this with some moms. You’re “going” all day and then you al most need something to help you calm down at night, because you’re always in this high output.
The second one, “wired and tired,” is when you are relying on willpower. I like a term I heard called “vertically ill,” which is where you feel sick but nobody around you knows that because you’re powering through it, even though you’re not feeling it. This could be where you’re perhaps experiencing depressive episodes, lack of motivation, thyroid issues or procrastination. That is something that I would do—I would procrastinate. It’s having that deadline right there in front of you that gets you fired up, gets you going and makes you function. But then you don’t have the ability to see the project through or finish it because you lose the motivation once you get three-quarters of the way there. There are addictions and an inability to concentrate. My little saying for this one is, “But first, coffee.” You’ve seen those T-shirts. I have one, so I’m not judging! You are relying on this outside energy so that you can keep going. It could be coffee, caffeinated drinks, or carbs all day long.
HG: Both of these so far sound like a lot of people I encounter and maybe even myself at times. Talk to us about the third type of adrenal fatigue or dysfunction.
KF: The third category would be “just tired” or maybe “burnout.” I hate to use the word “burnout” because then people say, “The adrenals don’t actually ‘burn out’ because they technically could still keep producing.” In this situation, you’re not describing the adrenals—you’re describing the person or the symptoms. That’s someone who can’t leave the house. I had gotten to this point. If I went to the grocery store, I would have to take a three-hour nap. My mom would have to prepare herself mentally for an hour to take a shower and things like that. That’s a pretty advanced case. You’re apathetic. You’re not as interested in things. You don’t want to go out anymore. You’re extra sensitive—not just to environmental things but also your feelings. This one, the saying is, “I like to party,” and by “party,” I mean “take naps.”
HG: I overheard someone saying, “My idea of a great birthday is just napping and having someone feed me.” She might fall into this category.
KF: Some people want to toss this framework because they think of it as, “You’re describing the adrenals,” but as I said earlier, you’re describing the person’s symptoms. Also, the framework is not progressive—you don’t go to “one,” then “two,” then “three.” You could go “one to three,” or you could be in a state where you’re tired and maybe you nourish yourself and get enough rest and your body can recuperate. You can move in and out of these categories at any given time. I personally have identified with all three.
HG: You say that our hormones are the lens through which we see the world. What do you mean by that?
KF: Your emotions are made up of many different things, and your physical body influences your emotions. Your cortisol is a stress hormone. If you are always in a hyper cortisol state, is it because your situation is stressful or because this particular hormone is circulating that causes you to perceive the world as more stressful? It can be the same thing with adrenaline. If you’re constantly outputting that, you might be a more fearful person, or you could dig into the neurotransmitters, such as GABA. If your GABA is out of function, then you could constantly be lethargic. Your personality is also part of your physical biology.
HG: I’m glad you’re shedding light on this because sometimes with friends I think, “They just need to change their mindset. They need to be more positive, and it’s how they perceive things.” What if it’s not their state of mind that is affecting how they see the world but these hormones?
KF: I was like that. I was a negative, glass-half-empty person. As I started getting healthier, I started having positive thoughts. I distinctly remember the first time that happened. I was sitting and thought, “Is this what it feels like to think positively?” I was in a situation with friends, and the friend was complaining about something, and I put a positive spin on it. He stopped and looked at me. He said, “Did you just say that?” I said, “I did just say that!” Your personality is not always who you are. As you get healthier, that can change.
HG: That is super encouraging. Now, let’s say you’ve identified your symptoms. You’ve decided that you are “wired and tired” or perhaps “just tired.” What’s next?
KF: You don’t want to go out and take the first adrenal thing that you find on the shelf. It is important to work with someone who is knowledgeable. If you’re someone who’s overproducing, and you take a supplement that gives you more energy, then you’re going to be exacerbating that dysfunction. Likewise, if you’re someone who’s downregulated and tired, and you’re taking something that’s calming you down, then you’re going to feel worse, not better. You can make the dysfunction worse.
The first thing is to stop fueling the fire, not go straight to the supplements. Work on the things that are broad and help your health in general. Remove the toxins from your physical environment. Work on a good whole-food, properly prepared, nutrient-dense diet. Deal with the stress in your life. Once those things are done, then I would recommend testing and not guessing where you are in the spectrum. You could do an adrenal salivary test, which would show you your cortisol rhythm throughout the day—because it’s not static. You should have higher cortisol in the morning and lower in the evening, and that can be dysregulated. In the context of a good clinical history and any issues that you’re having, you can take a targeted approach in how you add supplements.
There are some basic supplements that I do like. If you are in the “wired” category, things like ashwagandha, reishi and vitamin C are all good for helping you to calm down and nourish your adrenal glands. If you’re in the “wired and tired” category, you’re looking for primarily adaptogenic things. “Adaptogenic” means if you’re upregulated, it will calm you down. If you’re downregulated, it will pick you up. That would be things like rhodiola, crossandra, licorice and maca, which I like a lot. If you’re in the “just tired” category, you’re going to focus on nourishing your adrenal glands. That would be where organ meats come in handy. I’ll do glandular supplements for the hypothalamus and pituitary to work on the axis as a whole, and then stuff like ginseng and cordyceps.
HG: What about making some lifestyle changes? I was in the “wired” category for a long time. I would keep going and going, and then when I started getting morning sunlight, it helped me shift my rhythm. I became more tired earlier in the evening. I know my sleep became more profound. That helped me shift. Are there lifestyle changes you would recommend to move people from these categories into having a healthier HPA axis?
KF: It depends on the person. If someone’s so exhausted, then it might be prudent to start with supplementation or something to get the “oomph” to make those lifestyle changes. If they are in a place where they can make those changes, those changes are going to be important.
Number one is making sure that you have balanced blood sugar. If you have dysregulated blood sugar—not necessarily even diabetes, but insulin resistance or hypoglycemia—if you have any dysregulation, then the adrenal glands are not going to be able to recover because blood sugar and adrenal function are very closely related. Again, that would be number one.
Second, make sure your elimination pathways are open. Make sure that you’re going to the bathroom at least once a day. If you’re not, then that would an important point.
You mentioned restorative sleep which is where you’re repairing and detoxifying. That’s very important, too. I also have a list of restorative practices that are beneficial, not just for this but for many things. That would inlcude breath work, vagal massage, detox baths, Epsom salt baths, grounding, spending time outside (as you said, exposure to daylight helps the circadian rhythm), journaling and emotional awareness. You’ve had people on the show who have talked about German New Medicine and being aware of your emotions. We talked about perceived stress. That’s profound, and getting a jump on that would be helpful.
HG: What would you say to the skeptic? You may be able to detect issues with their adrenal function, but they say, “I’m doing fine. I take many trips to Starbucks during the day and pop my little candy when I’m feeling low on energy. I’m functioning great!”
KF: That’s tough. I used to be that person, so I’m trying to think what changed me. You come to a point where the pain of staying where you are is greater than the pain of change. A person has to get to that point first. I don’t know that you can convince someone who believes that they’re fine. I used to be that person who thought I was fine, but deep down, you know you’re not fine. To me, it’s not nagging a person but being there for them and having the information for them when they’re ready.
HG: Can you tell us one more story of a client you’ve worked with who was able to move out of one of those stages, “wired and tired” or “just tired,” using some of these supports you’ve been talking about?
KF: Specifically for adrenal issues, that’s a little bit hard because I practice a little bit differently than most people. Even though I specialize in the adrenal area, I’m also working on gut health and other things. My clients will consistently come to me tired. This is a topic for a different talk, but I do muscle testing to determine what area we’re going to go into when we do the supplementation piece. It’s cool every time to see how muscle testing reveals to someone what is wrong and their eyes light up. They say, “I knew this was the answer for what I’ve been dealing with.”
The clients with fertility issues are the ones who feel like I “get” them. You’ll have women who have not been able to conceive for years. You find that one right thing, that one little missing piece in their overall person—whether that’s gut, adrenal or both—and then, a few months later, they’re pregnant! That’s my favorite.
HG: As you’re talking, I can’t help but think about how I’ve never seen this sense of exhaustion before, especially in young people. It’s only happened in the past few years.
KF: We display it. Those three sayings that I ascribe—the three stages— those are printed on T-shirts. You see women posting them on their bios for Facebook or Instagram. They almost become our identity, which is a little bit scary, too, because it doesn’t have to be that way. You don’t have to live needing your rosé every evening.
HG: If readers could do one other thing to improve their health, whether related to adrenal function or not, what would you recommend?
KF: I’ve thought about this for a long time, especially listening to other podcast guest’s answers. When I hear other answers, I’ve thought, “That’s so good. Sleep is good and getting outside is good. Eating organ meats, those are all good things.” But I’ve asked, “What is the thing that gets you there?” I think it’s taking ownership and responsibility for your health and not outsourcing that to someone else. You’re the one who has the power to change your life and that takes acknowledging where you’re at and being truly honest and authentic with yourself. Moving that a step forward and saying, “Now I know where I am. I’m going to do something about it because I have a purpose and a mission on this earth that I need to accomplish.” You cannot accomplish that if you’re sick.
This was Wise Traditions Podcast episode 427 (July 3, 2023).
REFERENCES
- Lyke K. The HPA axis: hypothalamus-pituitary-adrenal: an introduction to the major hormones that operate and maintain the body. Wise Traditions. Winter 2017;18(4):13-24. https://www.westonaprice.org/health-topics/modern-diseases/hpa-axis-hypothalamus-pituitary-adrenal/
- Pottenger’s Cats – A Study in Nutrition (on Future Generations). https://www.youtube.com/watch?v=wGlSK39ZnCw&ab
- Tan SY, Yip A. Hans Selye (1907–1982): Founder of the stress theory. Singapore Med J. 2018;59(4):170-171.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2023
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