What chronic fatigue after 60 actually is
Dr. Martin has one name for it. Adrenal exhaustion. Not a mystery, not a label of exclusion, and not something you get told to live with.
He is not speaking off the cuff here either. He wrote his doctoral thesis on chronic fatigue, and the work behind it was a questionnaire he ran with at least 500 women, written up afterwards. What he found in that group is the spine of this whole episode.
Two glands the size of chestnuts, sitting on top of your kidneys, are the thing he says went wrong.
What cortisol is meant to do in a day
Start with the normal version, because the abnormal version only makes sense against it.
Your adrenals secrete adrenaline and cortisol. Cortisol is the longer acting one. It raises your blood sugar and it is what the body uses to wake you up in the morning. He is careful about this: you do not want to get rid of cortisol. You need it.
Dr. Martin on the daily rhythm:
Dr. Martin, The Doctor Is In, Episode 1460So cortisol really should follow your circadian rhythm.
It starts climbing around four in the morning. Your heart rate lifts a little. It pulls you out of rest and digest and gets you up. By the middle of the day it is coming down, and by evening you are back in rest and digest with cortisol low. Or, as he says, it should be low.
That is also why he is not a fan of judging anyone on a fasting blood sugar taken first thing. You are waking up, so the number is up. That is the rhythm working.
What happens when it never comes down
Here is the finding.
Dr. Martin on what he found:
Dr. Martin, The Doctor Is In, Episode 1460And what I found is people with chronic fatigue syndrome had high levels of cortisol all the time.
All the time. Not a spike in a crisis and back down, which is what the system is built for. High at four in the morning, high at midday, and still high at ten at night when it should be flat.
And a gland that is being asked to run flat out does not stay the same. He brings in a research finding he clearly found striking.
Dr. Martin on exhausted adrenals:
Dr. Martin, The Doctor Is In, Episode 1460And what they're finding back in the late eighties and nineties, I didn't know this, that the adrenal glands, when they get exhausted, they actually shrink to the size of a pea.
Chestnut down to a pea. That is the picture he wants you holding when you say the word exhausted.
The four drivers he found
Four common factors came out of those questionnaires, and they turned up again and again in the same women.
- Food, and sugar in particular. The thing he never leaves off a list.
- Environmental load. What the body is dealing with from the world around it.
- Long emotional stress. Not one bad week. Years of being uptight.
- Sleep problems. The one that closes the loop.
On the third, he is careful to say fight or flight is not the problem. It is in your body and it is supposed to be. Someone startles you, the hair on the back of your neck goes up, you fight or you run. Fine. The women he studied had been in that state for a long period of time, and that is what drains the glands.
On the fourth, listen to the circle he draws. Your cortisol is high, so you do not sleep properly. You do not sleep properly, so your cortisol is high.
Dr. Martin on sleep:
Dr. Martin, The Doctor Is In, Episode 1460Cortisol is meant to keep you awake, not to put you to sleep.
The signs he looked for
These come out of his own case notes, and out of the book he rewrote as Energy Robbers and the Fatigue Cure.
The first is cognitive. Brain fog. He describes what patients described to him, cotton in the brain, trouble focusing, memory not quite what it was. He likes the term because it is what it feels like from the inside.
Dr. Martin on a sign he saw over and over:
Dr. Martin, The Doctor Is In, Episode 1460One of the common things that we saw was they got dizzy upon standing quickly, their blood pressure went down while the adrenals are affected.
Stand up fast, the room swims. Most women over 60 put that down to age. In his group it sat with everything else on this page.
Why the thyroid gets dragged in
Almost all of them, he says, had a messed up thyroid with no diagnosis. Symptoms everywhere, blood work that came back fine, and nothing done.
He explains the route. When the adrenals get exhausted, the body robs progesterone. Progesterone drops, estrogen is dominant by comparison, and a dominant estrogen slows the thyroid. So the fatigue, the weight and the cold hands are not three separate problems. They are one picture with three faces.
That is the argument he makes in full in the thyroid never acts on its own.
Where fibromyalgia fits
He does not treat fibromyalgia as a separate country. In his questionnaires, the women who arrived with a chronic fatigue syndrome diagnosis and the women who arrived with a fibromyalgia diagnosis came back with the same four factors underneath.
Different label on the file. Same adrenals.
What to work on first
His four drivers are also his to-do list, in the order a woman over 60 can actually act on them.
Food first, because sugar is the one he names and the one you control three times a day. Then the stress load, and that means the long-running kind, the thing that has been sitting on you for years rather than the thing that annoyed you this morning. Then sleep, because it is the loop that keeps the other three going.
None of that is a diagnosis and none of it is a dose. Fatigue has plenty of other causes worth ruling out, and this is a podcast episode, not a consult. Take the list to someone who can check the rest.
Common questions
What causes chronic fatigue in women over 60?
In Dr. Martin's reading it is adrenal exhaustion, and the marker he found was cortisol running high around the clock instead of following the daily rhythm. He names four drivers: sugar, environmental load, long emotional stress and broken sleep.
What are the signs of adrenal exhaustion?
The ones he lists from his own cases are brain fog, getting dizzy when you stand up quickly because the blood pressure drops, and thyroid symptoms without a thyroid diagnosis.
Is fibromyalgia the same thing?
He puts them in the same picture. In his case series the women diagnosed with chronic fatigue syndrome and the women diagnosed with fibromyalgia shared the same four factors.
Why am I dizzy when I stand up quickly?
He saw it often enough in adrenal exhaustion to put it on his sign list, and he attributes it to the blood pressure dropping while the adrenals are affected. It has other causes too, so get it looked at.
Read next: How To Lower Cortisol After 60, Naturally and When Is Cortisol Highest? The Daily Cortisol Curve After 60.
Cortisol, from the clinic shop
Cortisol Control Formula is the formula the clinic shop sells for cortisol, the hormone at the centre of this episode.
60-day money-back guarantee. Fatigue has many causes. See your practitioner about anything new or persistent, and about anything you are prescribed.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
