Did you know that Burnout Syndrome was officially listed in the International Classification of Disease by the WHO (World Health Organization) in 2019? There are usually numerous signs, prior to burnout, that indicate things may be out of balance. Identifying these signs and knowing what functional tests are available, can streamline treatment and help you feel better faster.


The stress response.

Fatigue, poor sleep, weight gain, brain fog, GI and/or hormonal disturbances are the most common concerns I see today.

Cortisol is your stress hormone. It plays a huge role in our energy, metabolism, sleep-wake cycle and immune system. During times of stress, cortisol primes our body for the “fight or flight” response. Back in the day, an example of a typical stressor would be an attack by a predator. Our stress response prepares our body to run away or fight off the threat. This was great. It allows for a burst in energy as our metabolism kicked into gear, increased alertness and gives us a boost in immunity.  As the stressor is resolved (i.e. the predator runs off), our body regains its balance.


Impact of Cortisol on your body.

Cortisol is an essential hormone. It protects us and engages our survival mechanisms. Some of the effects of cortisol include:

  • Breakdown and release of glucose stores
  • Mobilize fats
  • Breakdown protein
  • Boost immunity
  • Divert blood from digestive tract, and send it to our limbs – to energize our skeletal muscles


What happens with chronic stress?


In this modern day and age, stressors are all around us. We live in a very busy world, with a ton of stimulation during most of the day. Noise, pollutants, over-exercise, refined foods, screen time, these are just a of few of the daily stressors present. This means that cortisol is constantly being released, leading to an excess cortisol state. However, overtime the resiliency of our adrenal glands may diminish and can result in burnout. This is known as “adrenal dysfunction” or “HPA axis dysfunction” (hypothalamus-pituitary-adrenal dysfunction).


During chronic stress, the pattern of cortisol secretion is irregular, which may be indicated by several signs.


Signs of adrenal dysfunction:
  • Fatigue, energy dips (i.e. afternoon crash, burst of energy in the evening) – cortisol impacts our energy
  • Insomnia or unrefreshing sleep – cortisol regulates our sleep-wake cycle
  • Digestive issues – cortisol diverts blood from our digestive tract
  • Hormonal imbalances (i.e. PMS, hypothyroidism) – cortisol impacts our hormonal resources
  • Low motivation or mood – cortisol impacts alertness and energy resources for our brain
  • Abdominal weight gain – cortisol increase abdominal fat deposition for storage (a part of survival mode)
  • Frequent colds – chronic cortisol will confuses the immune system


I think I have adrenal dysfunction – what can I do?


Recognizing the signs of adrenal dysfunction listed above and seeking support is the first step in resolution. Your body is resilient. When given the appropriate tools, it will find its way back to balance. As we know, adrenal dysfunction can impact several different systems. Several different avenues of functional testing are available depending on your presentation. 

Functional testing for adrenal dysfunction.
  • 4 point cortisol: This test helps map out your cortisol curve and informs us of the secretion pattern throughout the day. This may help us determine the stage of adrenal dysfunction you may be in. 
  • DUTCH Complete hormone panel: This comprehensive test evaluates your cortisol curve, hormone metabolites and sex hormones. Chronic stress can pull resources away from the production of other hormones. This test may be valuable if you’re experiencing other hormonal imbalances (such as PMS or fertility concerns) in addition to adrenal dysfunction. 
  • Thyroid panel: Our adrenal function is tightly related to how our thyroid performs. Running a thyroid panel informs us if the thyroid is functioning well, or if it needs to be supported concurrently.
  • Gastrointestinal testing: Chronic adrenal dysfunction may lead to gastrointestinal issues such as colitis, IBD, IBS, or gut infection. These factors can cause additional stress on the system, which doesn’t help. Identifying and treating issues with the gut may help reduce the stress load on the body.


Functional testing provides information on how different systems are performing. This allows us to streamline and tailor treatment protocols so you feel better, faster.


Feel like this may be you and want to take a proactive step? Book in for a free 15 minute phone consult to learn more.


– Dr. Ashley Damm, ND
Naturopathic Doctor, Vancouver BC.



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  2. Romm, A. (2017). The Adrenal Thyroid Revolution. New York: HarperCollins.
  3. Walter, K. e. (2012). Elevated thyroid stimulating hormone is associated with elevated cortisol in healthy young men and women. Thyroid Res. , 5-13.
  4. Xinghua, G. e. (2018). Chronic stress promotes colitis by disturbing the gut microbiota and triggering immune system response . Proc Natl Acad Sci USA , 3207.