Adrenal Fatigue: Signs, Symptoms, and Solutions

Worn out. Unmotivated. Achy. So tired. Depressed. These are just some of the words people use to describe adrenal fatigue. Others are wired, anxious, and overstimulated.

The most frustrating part is that those with adrenal fatigue are often ambitious, driven, and hard-working. Yet, exhaustion makes it difficult to function.

Don’t be surprised if you have all the symptoms, but your doctor hesitates in making an adrenal fatigue diagnosis. Many conventional doctors don’t recognize the term adrenal fatigue. However, most understand the concept and see numerous patients with its symptoms.

Had I not seen the effects of adrenal fatigue first hand in my wife, I might not comprehend how debilitating it can be.

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What is adrenal fatigue?

Your adrenal glands act in concert with the hypothalamus and pituitary glands. This relationship is called the hypothalamic–pituitary–adrenal (HPA) axis. 

Many practitioners prefer the term HPA Axis Dysfunction instead of adrenal fatigue when discussing a patient’s symptoms.

Your adrenal glands produce and secrete four stress-related adrenal hormones:

  • Cortisol
  • Aldosterone
  • Noradrenaline
  • Epinephrine

The pituitary and hypothalamus produce additional hormones, too. However, cortisol plays the most significant role in adrenal fatigue.

Your adrenal glands secrete cortisol according to circadian rhythm and in response to mental or physical stress.

Normal Cortisol Rhythm

Naturally, cortisol peaks in the morning to wake you up. The rise in cortisol provides a jolt of energy to get you up and out of bed so you don’t feel the need to hit the snooze button repeatedly.

From the time you wake up until around noon, cortisol levels drop significantly. As the afternoon and evening progress, the remaining cortisol continues to decline, reaching a low point around bedtime. The low level of cortisol and peak in melatonin helps you get to sleep and stay asleep.

Cortisol and Stress

Stress stimulates the release of cortisol, noradrenaline, adrenaline, and aldosterone. 

Cortisol, noradrenaline, and adrenaline increase heart rate, blood flow, energy, and mental acuity, and enhance your reflexes. Aldosterone increases fluid retention, raising blood pressure. These effects are helpful when dealing with a threat.

Once the threat is neutralized or avoided, the hormones and their metabolic effects return to normal.

However, issues arise when stress is chronic, and you don’t have sufficient time to recover from it.

Stress and Recovery

Stress is part of life. It is necessary for growth, learning, and physical and mental adaptation.

The stress of intimate relationships makes you adapt and develop empathy. Without it, you’d remain a selfish person who thinks the rest of the world should believe what you do.

Your business or career’s stress causes you to think differently, develop new strategies, and communicate your ideas differently, so others listen. Without that stress and the adaptation to it, your career or business would flatline.

The stress of weight training causes your bones to get denser, your muscles get stronger, and your nervous system becomes more coordinated. Without the stress of weight training and the adaptation that follows, you’d be more likely to develop diabetes, osteoporosis, and multiple other diseases.

As good as these stressors may be, their benefit only comes to fruition through the recovery that follows the stress.

Without the ability to recover, your body can become overloaded by stress, leading to adrenal fatigue.

Adrenal fatigue is a state of diminished resilience.

Adrenal fatigue is a state of diminished resilience, not necessarily an excess of stress. The solution isn’t to escape from stress, but it is to rebuild your resilience.

With the combination of constant stress and insufficient time or ability to recover, your cortisol rhythm changes, leaving you feeling like one of the three descriptions below.

As a side note, men and women respond differently to stress, which is why men are at a greater risk of certain diseases than women, and visa versa.

Our findings are consistent with the observation that men and women have a different risk for certain diseases. Women are more likely to develop autoimmune diseases and disorders that have been linked to underactivity of the HPA axis such as PTSD and panic disorder, whereas men are more likely develop diseases such as diabetes mellitus and cardiovascular disease that are thought to be secondary to high glucocorticoid allostatic load which results from over activation of the stress system.

Stephens, et al.

Three Stages of Adrenal Fatigue

Depending on the length of time you’ve been dealing with it, and the severity of stress or lack of recovery in your life, you’ll find yourself in one of three stages.

  1. Excited and anxious: When cortisol is high all day long, you can feel anxious, irritable, tense, and overstimulated throughout the day.
  2. Tired and wired: When cortisol levels fall in the morning and rise at night, you have trouble falling asleep at night and can’t get out of bed in the morning. You turn into a night owl with cravings for junk food.
  3. Chronically fatigued: Chronically high cortisol is bad for you. Research shows it can even shrink your brain. So, if cortisol levels remain unchecked, adrenals stop producing cortisol as a way to protect your body and mind. With constantly low cortisol, you feel wiped out all the time.

Symptoms of Adrenal Fatigue

The table below outlines some of the most common symptoms of adrenal fatigue.

Adrenal Fatigue Symptoms
Body achesDecreased motivation
DepressionDifficulty getting out of bed in the morning
Difficulty going to sleep at nightInability to handle stress
Increased cravings for salt, fat, and sugarLow energy levels
Muscle weaknessSkin discoloration (hyperpigmentation)
Suppressed or overactive immune systemWeight gain

The problem is, those symptoms are similar to a number of other issues, including:

Adrenal insufficiency and Addison’s Disease share some of the same symptoms as well, but are serious medical conditions and should be dealt with through an experienced endocrinologist.

An experienced endocrinologist will diagnose and treat a patient with these and similar diseases. The Endocrine Society provides specific guidelines for medical doctors to treat adrenal insufficiency here.

Doctors usually identify adrenal fatigue through a combination of saliva and blood tests.

Test your cortisol levels.

The Thorne Stress test measures salivary cortisol and DHEA throughout the day. This is the most common test for identifying adrenal fatigue.

How You Develop Adrenal Fatigue

You compromise your capacity to recover three ways. I’ll use exercise as examples.

1. Chronic low-to-moderate stress

The first way you can develop adrenal fatigue is to take on more than you can handle. You say yes to too many things.

As an example, you follow a well-designed fitness program. You’re excited about the results you’re getting, and want to get them even faster. So you add some additional high-intensity training sessions outside of your planned workouts. Then you do some additional group fitness classes, and start going to jiu-jitsu once a week.

If you had followed the original program, you would have continued to make progress. But by taking on too much, you cannot recover, and you begin to regress. You get weaker, lose motivation to exercise, and might even get injured.

Low-to-moderate chronic stress breaks you down over time, physically, mentally, or emotionally. It isn’t any single stress. It’s the constant exposure to too much total stress and too little recovery.

2. Trauma

Though it’s less common, some people overload their stress response system by exposure to unexpected or extreme stress. It could be the death of a loved one, the loss of a job, or a traumatic event.

I’ll use exercise as an example again. Let’s say you worked your way up to a 135-pound deadlift. You get the gym and feel super-motivated and energetic.

You think, “I did 135 pounds easily last time. I wonder if I could do 225 pounds.” So you load up the bar, grip it and pull with everything you’ve got.

Amazingly, you lift it. You set the bar down, feeling ecstatic.

The next morning, you wake up and cannot move. Everything hurts. You spend the next week in bed, taking extra supplements, anti-inflammatories, and painkillers like they’re Pez candies.

This form of stress could also be called trauma. When you’re exposed to something way beyond the level of stress you’ve experienced before, that single situation can cause severe, long-term damage. You can work your way back from it, but you first have to understand its impact on you.

3. Compromised recovery

While “stress” takes the blame for numerous ailments, including adrenal fatigue, stress isn’t necessarily the cause. Instead, lifestyle and nutrition choices limit people’s ability to recover.

Using exercise as an example again, let’s say you follow a well-designed strength training program to the letter. You push yourself as hard as possible, use flawless technique, and time your rest periods with a stopwatch. You do everything right for your 60 minutes of gym time four days per week.

But you only get six hours of sleep each night, your diet is low in protein, vegan, and loaded with fruit and processed foods, and you regularly lose your mind by tuning into politics each day. Also, the only supplement you take is an energy drink from the gas station.

You’ll quickly find yourself feeling weak and foggy-headed with bags under your eyes and a belly growing faster than that of a pregnant woman.

This is how most people end up in adrenal fatigue. It’s not that the stress in their lives is the problem. It’s that their diet, lifestyle, and exercise choices compromise their capacity to recover from stress.

We need to stop blaming stress and bastardizing struggle. Instead, we need to think, live, and eat in a way that allows us to handle stress.

How To Overcome Adrenal Fatigue

To overcome adrenal fatigue, you must rebuild your resilience. It’ll take commitment, persistence, and patience. But if you stop sabotaging yourself, you can feel the vigor and vitality you hope for. The following are the key factors that support your recovery from stress and help your adrenal glands function as they’re supposed to.

Sleep seven+ hours each night

You can never drink enough coffee or other stimulants to make up for sleep debt. For your body to repair itself, you need sufficient deep sleep. For your brain to function correctly, you need adequate REM sleep.

Some adults need as much as nine hours of sleep each night for months to rebuild their resilience.

GOYA (Get off your…)

Get off your a$$. Take 15 minutes mid-morning and mid-afternoon and go for a walk, read something entertaining, play cards, or do something that relieves your mind from thinking and your body from sitting.

We bought a small trampoline for our grandson, and I often use it during the day as a short break from sitting at my desk.

Movement helps lower cortisol levels, as does stepping away from the chaos of your inbox.

Interestingly, smokers have lower stress levels, not because of the nicotine, but because their smoke breaks force them to get away from work more often than non-smokers.

Have sex

There isn’t a drug or supplement that can compare to the impact sex has on neurotransmitters and hormones. Of course, most of the positive benefits occur in a committed relationship (marriage).

Sex might feel like a ton of work when you’re burned out or fatigued, but it does impact your stress response and mental health in a positive way.

Frequent and regular sexual activity is correlated with better mental health, reduced depression symptoms, better measures of stress management (heart rate variability), and lower blood pressure.

Prolactin and oxytocin levels rise after orgasm, helping to bond partners, reduce stress, and possibly support sleep. A Swedish study showed a strong correlation between the frequency of intercourse between men and women and their mental health.

Follow a good strength training program

I’m not referring to Crossfit, p90X, Alpha Training, boot camp, or any other high-intensity resistance training program. I’m referring to basic compound movements done in three to four training sessions per week.

You need plenty of rest between sets, should not go to momentary muscle failure, and should keep the reps around 6-8 to avoid significant muscle soreness the next day. This is similar to how I design the workout plans for VIGOR Training.

If you have adrenal fatigue and work with a personal trainer who recommends Crossfit, p90X, Alpha Training, boot camp, or any other high-intensity training program, fire your trainer. 

The goal is to provide moderate physical stress and then allow sufficient time and nutrition to recover from one session to the next. Weight training slowly helps retrain your body’s and mind’s stress and recovery process.

Walk often

Walking increases your oxygen uptake, which can improve mental clarity. Evidence also indicates that the repetition of walking…left, right, left, right…helps lower stress levels and calms the mind.

If you can walk outdoors, even better, as the fresh air can further help calm the mind, and if you want to take it another step further, walk through a forest. Research shows that the essential oils from trees in a forest help lower stress and cortisol levels.

Cut the cardio

Cutting cardio is hard to get others to wrap their heads around. That’s especially true with female clients. Stop running. Quit doing long cardio sessions or high-intensity interval training…for now. Cardio consistently makes the symptoms of adrenal fatigue worse, so please stop until you’ve rebuilt your health.

Eat a high-protein diet

If you read my article on high-protein diets, you know how essential protein is, and why so many people don’t get enough of it.

When you constantly fall short of optimal protein intake, you deprive your body of the essential macronutrient for growth and repair. Amino acids also play an important role in cognitive health and your body’s stress response.

Low protein intakes can cause higher stress levels, which is why it makes my skin crawl when someone following Keto tells others to eat less protein.

Take the Foundational Five

Before you delve into supplements to support your adrenal health, I recommend starting with my Foundational Five, the best supplements to support your health. Your metabolism won’t function without optimal intakes of essential vitamins and minerals.

  1. High-Quality Multivitamin
  2. Fish Oil
  3. Magnesium
  4. Vitamin D
  5. Digestive Enzymes

Avoid chronic carb or calorie restriction

Adrenal fatigue often leads to weight gain. To manage the extra weight, you might be tempted to cut calories or do Keto. Don’t.

Your body is already hypersensitive to stress. Adding the additional stress of calorie or carb restriction could make things worse, and won’t help you lose weight anyway.

Your priority should be to rebuild your health, then deal with the added weight.

If you need a nutrition plan to follow beyond eating more protein, use the following guidelines:

  • Eat your protein first at each meal or snack
  • Avoid all sources of gluten, dairy, and any other foods you may be sensitive to
  • Eat most of your carbs with your evening meal
  • Stop eating three or more hours before bedtime
  • Minimize alcohol consumption

By the way, cutting coffee won’t fix your adrenal fatigue. If you enjoy your morning cup of Joe without adding sugar, of course, go for it. Stop drinking it after mid-afternoon, but you don’t need to cut it completely.

Supplement to support adrenal fatigue symptoms

Provided you’re eating well and taking the Foundational Five, you might consider one or more of the following supplements.

  • Adrenal extract: Just as thyroid extract may support thyroid function, adrenal extract may support normal adrenal function. Unfortunately, it’s difficult to find research on the use of extracts, but there are plenty of people who’ve used it, myself included, and experienced positive effects.
  • Ashwagandha: Also known as Withania somniferais an adaptogen that helps the body maintain balance and has been shown to support healthy thyroid and stress levels. Adaptogens typically take more time to affect the body, so don’t expect to feel an immediate effect. It also supports muscle strength and recovery and helps maintain healthy body composition in adults under chronic stress.
  • DHEA is a precursor to testosterone, especially in women. DHEA is a hormone and should be used with the guidance of a healthcare practitioner. Men should only use it when having their sex hormones tested regularly, as it can cause the aromatization of testosterone to estrogen.
  • Essential oils: Certain essential oils, labeled as dietary supplements, may help support normal stress response, energy levels, and emotions.
  • Hemp oil: The research is quite compelling regarding the positive effects hemp oil has on stress and emotions. Read more about the numerous benefits of hemp oil here.
  • Lemon Balm: Also known as Melissa officinalis, lemon balm is often recommended in the traditional health world. Lemon Balm may mitigate the effects of mental stress, as well as lower acute feelings of anxiety.
  • L-theanine: Has been shown to stimulate alpha brain waves, which allow you to remain awake and alert while feeling a sense of calm. The purest form of theanine is Suntheanine.
  • Magnesium threonate: Magnesium threonate supports cognitive health and is the form of magnesium best absorbed by the brain.
  • Relora™: A proprietary combination of Magnolia and Phellodendron extract. Relora has been shown to cause feelings of relaxation and modulate the body’s stress response. It may also support normal DHEA levels in women and help maintain normal testosterone levels in men during periods of high stress.

One other note about supplements

Nature blesses us with dozens, even hundreds of plants that affect your body’s systems. To cover all of the supplements that could help with adrenal issues would require a thick book.

I’ve just highlighted the supplements that come up the most in conversations with other practitioners, and for which I’ve found the most evidence or first-hand experience.

Keep in mind, no two people respond exactly the same. If you consistently use a nutritional supplement, herb, or essential oil, and it doesn’t have the effect you’d hoped for after weeks or months of use, try something else.

Persist One Day At A Time

I have empathy for those who face adrenal fatigue. I saw first-hand how frustrating it was for Vanessa to do everything right while she waited for her body to respond to changes in her lifestyle and supplement plan.

The key is, no matter how frustrated you get and fatigued you feel, keep doing what you need to do in your Lifestyle, Exercise, Attitude, and Nutrition. You’ll work your way back to health and reclaim the vitality and fitness you had in the past.

References