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Adrenal Fatigue?

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Although adrenal fatigue is not considered medical diagnosis it has been demonstrated that when patients are given treatment to support their adrenals the symptoms associated with low functioning adrenals often resolve.  Could it be that laboratory evaluations may not be sensitive enough to detect slightly low levels of the hormones produced by the adrenals, but our bodies are?
Where are the adrenal glands?  What do they do?

The adrenal glands sit on top of the kidneys and are roughly the size of walnuts.  The gland itself can be actually thought of as two different glands combined into one since the center of the gland makes epinephrine and is under the control of the autonomic nervous system, and the cortex or the outer layer, is responsible for making different hormones (cortisol, DHEA, aldosterone, and sex hormones) under the control of the hypothalamus.

Cortisol is produced in response to stress, either real or perceived.  Cortisol raises blood sugar and blood pressure levels as well as moderating the immune function.  If the cortisol levels are low a person is often having symptoms of fatigue, low blood pressure, hypoglycemia, poor immune function, a tendency toward allergies and environmental sensitivities, and a lack of ability adapt to stressful situations.

Dehydroepiandrosterone sulfate (DHEA-S). Although its mechanism of action is not clear, DHEA is the most abundant hormone produced by the adrenal cortex. If it is low, you will probably feel pretty yuck.  DHEA-S levels normally decline with age.  Very low levels of DHEA have been detected in some people with type 2 diabetes, breast cancer, heart disease, osteoporosis and kidney disease.  Some individuals use DHEA supplements in order to protect against these and other health conditions.

Aldosterone helps to keep salt and water balanced in the body and controls blood pressure.

Estrogen and testosterone are produced in small but significant amounts by the adrenals as well as by the ovaries and testicles.

Signs of adrenal dysfunction:

  1. High Cholesterol: compensation for adrenal or hormone production especially in post menopause and andropause
  2. Thyroid dysfunction: low functioning rule out adrenal imbalance (high cortisol and low DHEA or low cortisol and Low DHEA)
  3. Glucose dysregulation: hypoglycemia with decreased adrenal function

Symptoms of low adrenal function:

  • Chronic allergic states (food, environment, related skin conditions)
  • Nervousness or irritability
  • Trouble concentrating especially before lunch
  • Excessive fear or apprehension
  • Easily confused
  • Mental fogginess, short term memory issues
  • Muscular weakness or lack of stamina
  • Alternating constipation and diarrhea
  • Stools typically dry and hard
  • Dull ache in belly can be anorexic esp. teens
  • Frequent or recurring respiratory infections
  • Slow recovery from illness
  • Increased PMS, Peri-Menopause or Menopause symptoms
  • Low Libido (due to low DHEA and decreased Estrogen and Testosterone)
  • Syncope or lightheaded when standing from sitting or lying down
  • Apathetic or loss of interest
  • Chemical sensitivities
  • Infertility

Diseases related to hypo-functioning adrenals:

Arthritis, Asthma, Hay Fever, Alcoholism, Fibromyalgia, CFS, Rheumatoid arthritis, other autoimmune disorders, and diseases where corticosteroids are often involved in treatment.  Also, metabolic disorders, obesity, type II diabetes, sleep disorders (insomnia, problems falling asleep, problems staying asleep, daytime sleepiness) can also be related to low adrenal function.

Energy pattern of adrenal fatigue: Low morning energy better around 10, but not fully awake until after lunch.  Afternoon low between 2-4 pm with the best energy after 6pm.  Could go to bed around 9-10 but usually stays up gets 2nd wind around 11pm and stays up until 1-2 AM.  The best sleep tends to be between 7-9 AM and the person tend to do their best work late in the evening.

Food Cravings associated with low adrenal function: salt, high fat foods, and caffeine.  Can become hypoglycemic especially under stress (shaky, dizzy, nauseous, prone to headaches).  Intolerant to high potassium foods especially in the morning (dried fruit, bananas, beans).

Treatment of Adrenal Fatigue

  • Lifestyle changes: 15 minute naps throughout the day recommended at 10am and between 3-5pm
  • Exercise: (not competitive) most days of the week
  • Go to bed roughly same time every night and try for 6-10h a night (depending on season)
  • Early to bed around 9pm
  • Sleep in when possible until 9am
  • Laughter: important to healing
  • Actively diffuse tension and stress
  • Minimize stress in life
  • Do not get out of bed in the morning until you think of something pleasant
  • Daily break for enjoyment
  • Regular relaxation and breathing exercises
  • Talk Therapy/meditation/hypnotherapy


  • Keep blood sugar stable throughout the day
  • Eat healthy – protein, vegetable, fruit
  • Stay hydrated
  • Avoid artificial sweeteners, stimulants
  • Avoid fruit in the morning
  • Emphasize veggies 5-6 servings per day
  • Allow salt to be added but prefer sea salt, celtic salt or sea salt with kelp powder
  • Avoid: hydrogenated fats, caffeine, chocolate, white food, junk food, allergenic or sensitive foods, fruit juice
  • Test for gluten sensitivity if digestion is an issue
  • The use of digestive aids might be indicated

Supplements:  Support adrenals with vitamin and mineral mix:  B complex, Vit C, Vit E, Calcium, Magnesium just to name a few

Herbs:  Asian Ginseng, Rhodiola, Licorice, Ashwaganda, and Maca

The extreme of low adrenal function is called Addison’s or adrenal insufficiency and is not as common as adrenal fatigue.  The opposite of Addison’s disease is Cushing’s disease or hyper-functioning adrenals leading to elevated cortisol and is often due to the presence of a tumor creating excessive hormone or from the over use of corticosteroids.

If you suspect you might have adrenal fatigue talk to your primary care provider about ways you can support and nourish your adrenals.  Consider taking an adrenal stress index (ASI) test to measure your cortisol throughout the day.  The test also measures your DHEA as well as some other important markers to assess adrenal function.  The ASI  is a saliva test so no blood is drawn and you can do it at home in your own time.

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