Nutrition, Lifestyle, and Supplements for Lyme Disease and Adrenal Fatigue

Lyme disease and adrenal fatigue

Are you dealing with Lyme disease and struggling to get out of bed in the morning, despite getting a solid 7-8 hours of sleep a night? Do you feel like you require caffeine to function or struggle to complete all the tasks on your to-do list each day due to overwhelming exhaustion? If you answered “yes” to any of these questions, you might be dealing with Lyme disease and adrenal fatigue. Read on to learn about why Lyme disease can cause adrenal fatigue, why we should really view adrenal fatigue as “HPA axis dysfunction,” and how nutrition, lifestyle, and supplements can improve symptoms of this condition.

Is Lyme Disease “Adrenal Fatigue” Real?

Your adrenal glands are small glands that sit on top of your kidneys, which are located in your lower back region. The adrenal glands make a variety of critical hormones, including cortisol (the quintessential “stress hormone”), epinephrine, and norepinephrine. These hormones, in turn, have a variety of crucial functions, including regulating your metabolism, immune system, and stress response.

“Adrenal fatigue” is a term often used in the integrative health world to describe a proposed under-functioning of the adrenal glands caused by chronic stress. Symptoms commonly attributed to “adrenal fatigue” include chronic fatigue, brain fog, weight gain, sleep difficulties, and a lowered stress tolerance. The premise of “adrenal fatigue” is that chronic stress places excessive demands on the adrenal glands, causing them to “wear out” over time. However, the problem with the”adrenal fatigue” concept is that it oversimplifies what happens in our bodies when we are under chronic stress from factors such as chronic Lyme disease, work-related stress, or relationship stress.

HPA Axis Dysfunction vs. Adrenal Fatigue and Lyme Disease

Rather than talking about the adrenal glands in isolation with the term “adrenal fatigue,” it’s more accurate to view these glands as part of a larger system called the “hypothalamic-pituitary-adrenal axis,” or the HPA axis for short. I know this term is a mouthful, but hear me out! The HPA axis comprises two glands in the brain – the hypothalamus and pituitary glands – and the adrenal glands. It is your body’s primary system that coordinates reactions to stress and resolves the stress response once the stressor has passed. This system worked beautifully in hunter-gatherer days, when most of the stressors we faced were acute, such as getting chased by a lion on the African savannah while hunting or foraging. However, chronic activation of the HPA axis is far more common in the modern-day world. Any source of chronic stress can strain the HPA axis, including physiological stress from chronic infections like Lyme disease! Combine Lyme disease stress with stress from other sources such as work, relationships, toxin exposures, and circadian rhythm disruption, and many Lyme patients are poised to experience HPA axis dysfunction.

In this diagram of the HPA axis, we can see that hypothalamus (indicated by the “hypothalamic PVN”) is located in the brain and signals to the pituitary gland. These two brain-based glands create precursors to stress hormones that are then produced in the adrenal glands. An excess of activity along the HPA axis can cause high cortisol and HPA axis dysfunction – check out the stressed out, anxious mouse! – whereas normal cortisol production results in a balanced, healthy mouse (and humans)! Photo courtesy of Int J Mol Sci.

Chronic activation of the HPA axis through continuous exposure to stressors, such as harmful bacteria, can lead to HPA axis dysfunction, where this system isn’t able to effectively regulate hormone production. Initially, HPA axis dysfunction can cause high cortisol levels and symptoms such as anxiety, belly fat gain, and brain fog. However, over time, the system can bottom out, leading to depleted levels of cortisol and other hormones, including estrogen, progesterone, testosterone, and DHEA. Depleted levels of these hormones adversely affect the health of our immune systems, gut, and brain. Not a good recipe for people with Lyme disease!

So, in summary, chronic activation of the stress response absolutely occurs in chronic Lyme disease. However, we should really refer to this response as “HPA axis dysfunction” rather than “adrenal fatigue. For simplicity, I will use these terms interchangeably throughout this article, especially since more people are familiar with the term “adrenal fatigue” than they are with “HPA axis dysfunction.” So, what are some of the symptoms of Lyme-induced adrenal fatigue, and what can we do about it? Let’s discuss each of these topics in turn.

Why Are Symptoms of Lyme Disease Adrenal Fatigue?

Individuals with adrenal fatigue, aka HPA axis dysfunction, caused by Lyme disease may experience a variety of symptoms, including:

  • Chronic fatigue
  • Feeling unrested after a full night of sleep
  • Anxiety
  • Depression
  • Brain fog
  • Frequent yawning
  • Disrupted sleep, including difficulty falling or staying asleep
  • Weight gain and weight loss resistance
  • High blood sugar
  • Insulin resistance
  • High or low blood pressure

These symptoms are triggered by changes in how the hypothalamus, pituitary, and adrenal glands produce stress hormones, as well as changes in how the body responds to the hormones. For example, suppose you are in the early stages of HPA axis dysfunction. In that case, you may experience a racing heart during the day or a “second wind” at night that makes you feel hyperactive and causes difficulty falling sleep. These symptoms can be triggered by high cortisol, epinephrine, and norepinephrine. However, if your body has been stressed out for a long time, your HPA axis may downregulate cortisol production to protect you from the harmful effects of prolonged high cortisol (such as bone density loss), causing symptoms such as chronic fatigue, low motivation, and difficulty getting out of bed in the morning.

Lyme disease-induced HPA axis dysfunction symptoms can range from inconvenient to debilitating. Correcting adrenal fatigue is vital for Lyme disease recovery because restoring healthy adrenal function can improve many Lyme symptoms, including chronic fatigue and brain fog. Furthermore, a healthy HPA axis is vital for proper immune system function, which you need to overcome chronic Lyme disease. The good news is that there’s MUCH you can do from a nutrition, lifestyle, and supplement perspective to restore healthy HPA axis function.

Correcting adrenal fatigue/HPA axis dysfunction is vital for Lyme disease recovery because it can improve many Lyme symptoms, including chronic fatigue and brain fog. Furthermore, a healthy HPA axis is vital for proper immune system function, which you need to overcome chronic Lyme disease.

~ Lindsay Christensen, MS, CNS, LDN, A-CFHC, CKNS

Testing for Adrenal Fatigue/HPA Axis Dysfunction

To test for adrenal fatigue/HPA axis dysfunction, we ideally want to see what our cortisol rhythm looks like throughout the day. In my functional nutrition practice, I prefer to use the DUTCH Plus test for this purpose. The “DUTCH” in DUTCH test stands for “Dried Urine Test for Comprehensive Hormones.” This test uses a combination of urine and saliva samples to assess the body’s diurnal (across the day) cortisol rhythm, including a unique measurement called the “cortisol awakening response” or CAR, which is the fluctutation in cortisol that should occur upon waking. The DUTCH test is an instrumental test that can help a qualified practitioner determine the stage of HPA axis dysfunction their client is in and the nutrition, lifestyle, and supplement adjustments that should be made to correct the imbalances.

Strategies for Addressing Lyme Disease and Adrenal Fatigue

Once it’s been determined that HPA axis dysfunction is an issue, a functional practitioner can help you take steps to restore healthy function of the stress-response system. Treating Lyme disease and any co-infections is crucial for improving adrenal fatigue because, left untreated, chronic infections create an ongoing strain on the body’s stress-response system. Ideally, you’ll need to partner with a Lyme-literate doctor to treat the infection. However, beyond antibiotics and herbal protocols for treating Lyme infection, there are many things you can do from a functional nutrition and lifestyle perspective to improve symptoms of Lyme-induced HPA axis dysfunction. Here are a few of my top strategies for addressing Lyme adrenal fatigue:

Avoid Processed and Refined Foods

The first dietary step you should take to support HPA axis healing and address symptoms like chronic fatigue is to remove processed and refined foods from your diet. A processed Standard American Diet (SAD) has been found to increase the biological stress response in animals. These effects may carry over into stressed-out humans too! (1) Part of the problem may be that the Standard American Diet is rich in high-glycemic-index (GI) carbohydrates, which are carbs that rapidly spike blood sugar; spikes in blood sugar can cause spikes in cortisol, signifying a stressful event to the body. (2) The chronic consumption of high-GI foods, such as bread, pasta, and cereal, may ultimately lead to perpetually elevated cortisol. Since high cortisol can also trigger unhealthy eating patterns, the consumption of high-GI foods can create a vicious cycle! (3)

Another benefit of avoiding processed and refined foods is that your immune system will function better and be more able to address Lyme disease! Refined carbohydrates sabotage the activities of various immune cells, effectively “distracting” our immune system from targeting foreign invaders, such as harmful bacteria. By removing these foods from our diets, we can give our immune systems a leg up in combatting Lyme disease.

Instead of eating the highly processed Standard American Diet, eat a diet rich in whole, minimally-processed, nutrient-dense foods. These types of foods will support a healthy HPA axis and mitigate symptoms of adrenal fatigue. If you need help figuring out what to eat to support your Lyme disease and adrenal fatigue recovery, I’d love to help you one-on-one in my functional nutrition practice! You can learn more about my practice here.

Eat Protein at Every Meal

Eating protein at every meal is crucial if you have Lyme disease and adrenal fatigue. Protein intake helps balance blood sugar and cortisol release, and can regulate cortisol levels inside the body. I recommend eating a portion of protein that is at least the size of the palm of your hand at every meal of the day. It’s especially important to eat at least 25 grams of protein at breakfast, since the foods you eat at breakfast can set the tone for your blood sugar and cortisol rhythms all throughout the day.

Eating protein at every meal of the day is crucial for balancing blood sugar. Balanced blood sugar, in turn, helps support healthy HPA axis function and Lyme recovery.

Prioritize Sleep

Sleep is a time during which our bodies prioritize rest and repair. A lack of sleep or disrupted sleep can profoundly disrupt your cortisol rhythm, causing dysfunction throughout the HPA axis. Through its impacts on cortisol, insufficient/disrupted sleep can drive chronic fatigue, weight gain, brain fog, compromised immune function, high blood sugar, and impaired exercise tolerance, among other symptoms. Therefore, you must optimize your sleep to recover from Lyme disease and adrenal fatigue! Numerous nutrition, lifestyle, and supplement strategies can help you optimize your sleep. However, covering all of these possibilities requires its own blog post! Here are a few low-hanging fruit that you should adjust to optimize your sleep:

  • Set aside time for 7-9 hours of sleep a night in a dark, cool room. Don’t underestimate the impact of light pollution and temperature on your sleep!
  • Avoid screens (computer, TV, phone) for at least one hour before bed.
  • Avoid eating anything 2-3 hours before bed. Going to sleep on a full stomach can cause difficulty falling asleep and induce restless sleep.
  • Cut off your intake of caffeine for the day at least by noon, if not sooner. Consuming caffeine in the afternoon can significantly interfere with the restorative quality of your sleep, even if it doesn’t necessarily impact your ability to fall asleep.
  • Supplement with magnesium before bed to help your body naturally wind down. Choose a bioavailable form of magnesium, such as magnesium glycinate or magnesium malate.

Try Adaptogenic Herbs for Adrenal Fatigue

Herbs can be powerful healing allies for the HPA axis, but it’s important to choose the right ones! Adaptogenic herbs, also referred to simply as “adaptogens,” are herbs that help the body adapt to stress. In my functional nutrition practice, I’ve found that adaptogens can be extraordinarily helpful for individuals with Lyme disease and adrenal fatigue because many of them have pluripotent effects, helping not only the HPA axis but also the brain, immune system, and thyroid gland. A few of my favorite adaptogens include:

  • Eleutherococcus senticosus, aka Eleuthero or Siberian Ginseng: This is a great herb for those with chronic fatigue and brain fog. I find that it synergizes well with many Lyme herbal treatment protocols.
  • Rhodiola rosea, aka Rhodiola: This small, hardy succulent plant has a long history of use in Siberia. It is energizing and may support the immune system.
  • Ashwagandha: This herb has long been used in traditional Indian Ayurvedic medicine and can be helpful for high cortisol and assisting the body in winding down, especially before bed.
  • Licorice root: Licorice root is a central herb in both traditional Western and Traditional Chinese Herbal medicine. It helps maintain healthy cortisol levels, keeping just enough of this hormone in circulation to support a healthy HPA axis without overwhelming the body. (4) If you are on any medications, it is especially important that you consult with your doctor before consuming licorice root in any form, since it can interact with many medications.

Manage Your Stress

No discussion of adrenal fatigue/the HPA axis would be complete without discussing stress! Mental and emotional stress create a significant drain on the HPA axis, especially if your body is already contending with a chronic physiological stressor like Lyme disease. It is crucial that you take measures to manage mental and emotional stress every day. In my practice, I find that many clients resonate with guided meditations, which you can access through convenient apps such as Headspace and Calm. Taking walks, spending time in nature, yoga, and talking regularly with a counselor are other helpful ways to manage Lyme-related and general life stress so that your adrenals/HPA axis can be less burdened by mental and emotional stressors.

Address Other Body Stressors

Finally, there are other physiological stressors besides chronic infections, mental/emotional stress, and lack of sleep that can stress out the HPA axis that you must address if you have Lyme disease, including:

  • Circadian rhythm disruption: Your circadian rhythm is an internal set of biological processes that cycles roughly every 24 hours, regulating your sleep-wake cycle and numerous other biological processes. Alterations in circadian rhythms adversely affect your HPA axis. (5) Practicing healthy sleep habits, getting sufficient sunlight exposure during the day, and avoiding blue light at night can all help support a healthy circadian rhythm.
  • Poor blood sugar regulation: Poor management of blood sugar causes swings in cortisol which, in turn, can impact drive adrenal fatigue. Engaging in dietary habits and lifestyle practices that support healthy blood sugar control is therefore key for helping your HPA axis recover during Lyme treatment.
  • Oxidative stress: Oxidative stress occurs when there is an imbalance between free radicals (reactive chemical compounds inside the body that “steal” electrons from your DNA, proteins, and lipids) and the body’s capacity to neutralize them with antioxidants. High levels of oxidative stress can drive adrenal fatigue. (6) Conversely, minimizing exposure to toxins that drive oxidative stress, such as mycotoxins and plastics, and eating an antioxidant-rich diet can help fortify your HPA axis against the harms of oxidative stress.
  • Gut imbalances: Imbalances in the good and bad bacteria in the gut, yeast overgrowth, and leaky gut can all drive adrenal fatigue/HPA axis dysfunction. Many people with Lyme disease have either pre-existing gut imbalances driven by infection or imbalances stemming from Lyme antibiotic treatment; you can read more about the Lyme disease-gut connection in my blog on this topic. If your gut is unhealthy, it will continue to drain your reserves and negatively impact your HPA axis. A functional healthcare provider can help you identify and correct potential gut imbalances using functional medicine stool testing, diet, and gut protocols that include compounds such as herbs, probiotics, and digestive support. I frequently guide clients with HPA axis dysfunction through gut protocols and have great success improving adrenal fatigue symptoms through these measures.

Final Thoughts

Lyme disease can drive adrenal fatigue not only because of the stress that chronic infections place on the body, but also because of the mental and emotional stress that comes with experiencing this illness. However, there is much you can do from a nutrition, lifestyle, and supplement perspective to recover healthy adrenal function and support a more resilient HPA axis. Try some of the strategies I’ve mentioned in this article; I bet you’ll notice a difference!

There are many health factors that can drive HPA axis dysfunction and it can be overwhelming and inefficient to try doing it all on your own. When possible, I strongly recommend working with a functional healthcare provider to identify and correct the specific issues that are driving your HPA axis dysfunction so you can reclaim your health and feel better faster!

Work with me in my nutrition practice! Are you uncertain about what to eat, what lifestyle practices to prioritize, and what supplements to take to support your Lyme disease recovery process? Consider working with me one-on-one in my functional nutrition practice! You can learn more about my practice and how we can work together here.

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