Stress and Adrenal Fatigue…aka Long-Term Fight or Flight

The fight or flight response is a direct result of adrenaline being released into the bloodstream. Anything that causes stress to the body will trigger a fight or flight response – being time poor, peak hour traffic, road rage, car accident, arguments, illness, heart attack, balancing credit cards, angry boss or work colleagues, deadlines, exams etc.
Before modern life, the fight or flight response was there to protect us from hungry animals or marauding tribes attacking us. When activated, the fight or flight response causes a surge of adrenaline and other stress hormones to pump through our body. This surge is the amazing force that is responsible for mothers lifting cars off their trapped children or people running back into a burning building to save a family member. We are capable of heroic and courageous feats that we wouldn’t normally be able to do. When faced with such dangers to our physical survival (or of our loved ones), the fight or flight response is life saving.
In our modern life, most of our stressors that trigger the fight or flight response are no longer physical. They’re still as effective at triggering adrenaline and other hormones, but we are still sitting in our cars, or at our desks, not fighting or fleeing for our lives. The physiological affect of these hormones is still as potent and the problem is, when they’re not used for physical survival, they continue to flow through our bodies, causing many long term health problems. Adrenaline is the first response hormone that gives us that surge of energy (caffeine triggers an adrenaline rush), but if stress is ongoing cortisol levels stay high which then impacts on our ability to sleep.

The physiological symptoms associated with fight or flight include;

  • rapid, shallow breathing (such as when we hyper-ventilate) to increase oxygen into the blood
  • cold, clammy skin because the blood is being diverted the arms, legs, shoulders, hands and feet, preparing you to be ready for action.
  • increased heart rate and blood pressure, to increase blood flow to the extremities
  • sweating, to release the expected heat that the body will develop while fighting or fleeing.
  • tightening muscles, ready to fight or flee, which will cause us to feel jittery and on-edge
  • Dizziness, because the blood has been diverted from a lot of the regions of the brain, as we don’t need to focus on complicated thinking
  • Heightened sense of smell and hearing
  • Dilated pupils (to allow in more light, therefore improving sight
  • tunnel vision (to allow us to focus on our target better)
  • decreased blood flow to the digestive tract, as it’s not a priority to digest lunch while you’re fighting for your life. Some people will suffer from nausea when they’re in fight or flight, as the body may be trying to remove any food from the gut. This will also mean your mouth may go dry.
  • For this same reason, you may need to suddenly go to the toilet.
  • sharp electrical-like shocks in your bloodstream as the adrenaline is released.
  • Increased clotting of the blood to stop us from bleeding to death, so quickly, if we’re injured. This can also mean extra cholesterol is made in preparation for repair to damaged blood vessels.

The effects of long-term stress, adrenal fatigue and fight or flight include;

  • over-active thought processes, we become fixated on looking for (often non-existent) stresses in life to be worried about
  • changes in appetite, for some it’s increased, for others it’s reduced
  • changes in body shape due to excess cortisol, which makes us store fat around abdominal organs, the classic apple shape
  • chronic muscle tension, leading to headaches and migraines, muscle tics and involuntary spasms, cramping muscles and TMJ (jaw) pain
  • loss of libido and reduced fertility
  • skin issues such as psoriasis or eczema, if there is a pre-disposition
  • increased risk of hair loss and balding
  • increased risk of asthma attacks

Stress leads to adrenal fatigue (or eventually burnout) by affecting the hypothalamic-pituitary-adrenal axis (HPA).


Here’s how;

The hypothalamus produces vasopressin and corticotropin releasing hormone (CRH). The hypothalamus is also responsible for the body’s circadian rhythm, internal temperature and energy levels.

Vasopressin and CRH are peptides that stimulate the pituitary gland (known as the master gland of the body) to produce and release adrenocorticotropic hormone (ACTH). The pituitary gland is also responsible for producing and releasing other vital hormones such as; growth hormone, anti-diuretic hormone and luteinizing hormone.

ACTH in turn stimulates the adrenal glands to produce cortisol which is the hormone that releases glucose into your bloodstream which is preparing your body for the high-energy ‘fight-or-flight’ response that it is expecting. Your adrenals also release adrenaline, which raises your heart rate and increases your blood pressure, all physiological responses in preparation for ‘fight or flight’. Other physiological effects of ‘fight or flight’ include; diverting blood from your gastro-intestinal tract and brain to your hands and feet, suppressing your immune system and increasing your blood’s clotting ability.


Normally, when enough hormones have been produced, a message is sent back to the hypothalamus and pituitary to stop producing more hormones.

The more stress the body is exposed to, the less effective the negative feedback loop becomes.The adrenal glands start to show signs of overuse such as the feeling of wired but tired. The glands themselves may be starting to thicken as a way of attempting to produce more hormones. The adrenal glands are still pumping out cortisol and adrenaline, but they’re struggling. Becoming more reliant on caffeine to get you up and going or staying awake later in the day is a classic sign that your adrenal glands are starting to suffer.


After repeated, ongoing exposure to stress, the return negative feedback loop doesn’t swtich off the hormone release from the hypothalamus and pituitary glands, yet the adrenal glands are really struggling to produce hormones and other hormones such as pregnenolone (precursor to sex hormones as well as cortisol), DHEA and testosterone are affected. Pregnenolone is stolen for the production of cortisol at the expense of producing sex hormones. The rest of the endocrine system start to try to compensate for the weakened adrenals, but this only leads to lower hormone and neurotransmitter levels elsewhere. Typical symptoms, at this stage, may include ongoing fatigue, a lack of motivation, lowered immune system (and therefore increased risk of infections) and a lower sex drive. The adrenal glands may be starting to shrivel. This stage can go on for several months or even years.


If stress continues, unabated, you will enter the final stage of adrenal fatigue, known as adrenal burnout. The body simply runs out of ways to manufacture stress hormones, and cortisol levels finally begin to drop. Now, the levels of both the sex hormones and the stress hormones are low. Levels of neurotransmitters are often also low. You may suffer from extreme fatigue continuously as well as a total lack of sex drive, irritability, depression, anxiety, weight loss, complete lack of motivation and apathy in hobbies and interests that previously  brought joy. By this stage, the lack of  hormones has major implications for almost every part of the body. Recovering from this stage needs considerable time, patience and often a total change in diet and lifestyle.


Ways to manage the long-term physiological effects of fight or flight;

Foods that calm the nervous system can help soothe our over-active thought processes;

  • foods rich in folic acid; dark leafy greens such as spinach, broccoli and rocket, citrus, lentils and beans, asparagus and eggs.
  • foods rich in vitamin B’s; meat (especially liver), fish, eggs, nutritional yeast, beans and lentils
  • foods rich in omega 3 fatty acids; fish, free-range eggs (that are really free-ranging, most supermarket eggs aren’t), nuts, seeds and root vegetables
  • foods rich in calcium; dairy, figs, fish with bones in it, seaweed, dandelion leaves and root
  • foods rich in magnesium; red meat, chicken liver, nuts and seeds, beries and green leafy vegetables. Unfortunately, a lot of our foods are deficient in magnesium and as we require so much of it, for over 350 different processes in the body, a supplement is often needed. Clinical strength powder form is the best. (not tablets from the supermarket).
  • foods and herbs to support and heal the nervous system; oats, borage, St John’s wort lemon balm, Brahmi, chamomile, lavender, passionfruit

Deep Abdominal Breathing,

such as Buteyko or Yogic Breathing


Because the fight or flight response is designed to prepare your body, physically, for action, either as fighting or fleeing, the adrenaline and other adrenal hormones continue to course through your body, if the body doesn’t actually do anything physical. Therefore it is imperative that you release these through exercise. Even running on the spot, or screaming out loud, can help release these. Regular, ongoing exercise is important to keep these hormones in check and to release feel good endorphins that keep you in the para-sympathetic or rest and digest state.
High Intensive Interval Training (H.I.I.T), is a really good technique for helping with the damaging effects of long-term fight or flight.

If you feel you’re suffering from long-term fight or flight or any of these stages of adrenal fatigue, please come and see me, it’s much easier to resolve in the earlier stages than putting off until you’ve reached burnout.