Adrenal Fatigue: Causes, 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. They’re also more often women than men.
Everyone experiences such symptoms in certain seasons of life. Those with adrenal fatigue often endure them for so long that they can’t help but feel hopeless.
I first learned of adrenal fatigue through Dr. Jim LaValle, author of The Metabolic Code. Dr. LaValle was one of the first healthcare practitioners to point out the connection between stress, cortisol patterns, and the symptoms of adrenal fatigue. My wife, Vanessa, found herself in the late stages of adrenal fatigue, and was fortunate to work with Dr. LaValle on her recovery. It took much prayer, patience, and persistence. Eventually, she worked her way through it.
Had I not seen first-hand how hard it can be, I would have never known the frustration people feel when dealing with adrenal fatigue.
I do need to mention that adrenal fatigue is not a recognized medical condition (yet).
Conventional doctors might raise their eyebrows if you suggest to them you might have adrenal fatigue. They’d be more likely to diagnose depression than consider adrenal fatigue (the symptoms are similar for both).
Adrenal fatigue isn’t a black and white condition. Though there are tests to measure certain aspects of adrenal function, the root cause is often a mix of lifestyle, exercise, attitude and nutrition choices.
In this article, I hope to:
- Provide a clear explanation of what adrenal fatigue is, as well as explain what else could cause similar symptoms
- Explain why the cause is not necessarily stress or cortisol, but your resilience to stress and your recovery from shots of cortisol
- Outline simple steps in your Lifestyle, Exercise, Attitude, and Nutrition choices to help you overcome the symptoms associated with adrenal fatigue and reclaim your vigor and vitality
I’ve kept the technical writing to a minimum. It might make me sound smarter to use big words, but I’m more interested in you getting the necessary points, and then taking action on them, than thinking “Wow! That was fascinating but I have no idea what to do.”
Cortisol Rhythm, Stress, and Recovery
Let’s begin with stress because it’s rare to find an article about adrenal fatigue without it being connected to stress and cortisol.
Your adrenal glands release cortisol in a daily rhythm and in response to a real or perceived stress. Your adrenal glands are part of the hypothalamic-pituitary-adrenal (HPA) axis, which governs many of your hormones.
In stressful circumstances, cortisol acts with the neurotransmitters adrenaline and noradrenaline to increase heart rate, blood flow, energy and acuity, and enhances your reflexes. Elevated cortisol is only detrimental when your diet, lifestyle, and exercise habits don’t allow you to recover from one release of cortisol to the next.
Neurotransmitter: Chemical messenger produced in the nervous system and carried through the nervous system to target tissues. Neurotransmitters are fast-acting, and their effects are short-lived.
Hormone: Chemical messenger produced by glands and other tissues, carried through the blood to target tissues. Hormones are slower-acting and longer-lasting.
Normally, cortisol levels peak in the morning, about the time you’re supposed to wake up. The rise in cortisol provides your body with fuel for energy and helps you hop out of bed and get on with your day (well, I don’t know anyone who actually hops out of bed), rather than hitting the snooze button three times.
From the time you wake up, until around noon, cortisol levels drop significantly. As the afternoon and evening progress, the remaining cortisol continues to drop, reaching a low point around bedtime. The low level of cortisol and peak in melatonin helps you get to sleep and stay asleep.
Stress causes cortisol to rise outside of its normal daily rhythm. The rise in cortisol helps you deal with the stress in the moment. It also helps stimulate the recovery process, so you adapt and grow stronger following the stressful event.
This is where adrenal fatigue fits in. It’s not necessarily the stress itself that causes problems. It’s the lack of recovery following the stress that leads to adrenal fatigue. When you don’t recover properly, your daily cortisol rhythm changes.
Stress and Recovery
Stress is part of life and 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 think as you do.
The stress of your business or career 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 to get stronger, and your nervous system to become 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.
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.
Three Stages of Adrenal Fatigue
Amped up and anxious: When cortisol is high all day long, you can feel anxious, irritable, tense, and overstimulated throughout the day.
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.
Fatigued all the time: 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 brain. With constantly low cortisol, you feel totally wiped out all the time.
Are You Sure It’s Adrenal Fatigue?
The table below outlines some of the most common symptoms of adrenal fatigue.
|Adrenal Fatigue Symptoms|
|Low energy levels||Decreased motivation|
|Difficulty getting out of bed in the morning||Difficulty going to sleep at night|
|Body aches||Increased cravings for salt, fat, and sugar|
|Inability to “deal” with stress||Depression|
|Muscle weakness||Weight gain|
|Skin discoloration (hyperpigmentation)|
The problem is, those symptoms are similar to a number of other issues as well, 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.
I can’t stress enough the importance of an annual, comprehensive blood test that covers all major markers of your internal health. Before deciding you have adrenal fatigue, eliminate the chance it could be something else. It would be a bummer to focus on fixing adrenal fatigue if you don’t even have it.
How You Develop Adrenal Fatigue
You compromise your capacity to recover three ways through:
- Chronic, low-to-moderate stress
- Acute, excessive stress
- Chronically compromising your capacity to recover
To explain how all this works, let me use an example almost anyone can relate to or imagine: strength training.
The purpose of strength training is to stress your muscular, skeletal, and nervous systems beyond the level of stress they’ve previously experienced.
I’ll use the deadlift, which is one of the five fundamental exercises.
Let’s say that the most weight you’ve lifted off the ground in the past year has been your 40-pound grandson. You join the gym and start working on your deadlift. Since you’re used to your 40-pound grandson, perhaps you start at 45-50 pounds and do a few sets of eight repetitions. Four days later, you use 55 pounds, and every three to seven days, when you do deadlifts, you lift a little more weight or do more repetitions.
The deadlift is the stress.
The time between deadlift sessions is your recovery period. With proper lifestyle, exercise, attitude, and nutrition choices, you adapt to the stress of the deadlift, so you’re stronger the next time you do it. Over time, you should be able to handle heavier and heavier weight. Basically, if you recover properly, you adapt to handle higher stress over time.
As a growing and maturing adult, that’s ideally how things work in all areas of our lives. We gradually get exposed to greater stress, and we recover and gain strength to handle more significant stressors in the future.
However, there are three ways we muck that up.
1. Chronic Low-To-Moderate Stress
The first way is that we lead ourselves towards adrenal fatigue is that we take on more than we can handle. We say yes to too many things. Each of them alone seems like they’re small commitments. But as they add up, they create more total stress than we can handle.
Let’s go back to the deadlift as an example. Because you’re getting such outstanding results from deadlifting twice a week, you decide to do deadlifts every day. Though a day of deadlifts by itself is not a big deal, the frequency with which you take on that stress is too often for you to be able to recover from it. Within a few weeks, you become weaker, more worn down, and might even get injured.
That’s how chronic stress breaks you down over time, physically, mentally, or emotionally.
2. Acute, Extreme Stress
Let’s use another example with the deadlift. You’ve worked your way up to a 135-pound deadlift. You arrive at the gym 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 the impact it had on you.
3. Chronically Compromising Your Capacity To Recover
I have one final example using the deadlifts. Hopefully, by now you can see how these examples relate to most other stresses in your life.
Let’s say that you followed the perfect strength training program correctly. It was designed to help you consistently build strength while allowing plenty of time to recover between training sessions.
However, between training sessions, you mainly eat processed food, low in protein and high in sugar and ingredients that cause inflammation, you get only six hours of sleep, you follow another trainer’s marathon training program on your off days, and your personal life is a disaster.
You see some initial progress from your program, and then start to regress. You get weaker, feel sore longer, and eventually get sick or injured.
You curse the strength training program and say it was too much of a stress.
Your training plan might superb, but you screw it up with what you do and don’t do between sessions.
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.
How To Rebuild Your Resilience
Rebuilding resilience won’t come from a pill or an extra cup of coffee. It requires a daily commitment, persistence, and patience. You need my LEAN approach to improving your health:
Though life is much better in many ways, the boundaries we once had in our lives have become blurry. Laptops allow us to work well past closing time from the comfort of our own homes, making it less likely we get any after-work activity before bed.
The boundaries between television time and bedtime have disappeared now that our favorite shows are available at any time of day. Get started on a new series, and six episodes later you realize you’ve stayed up through half of your sleep time.
Social media keeps you wondering what your friends are up to at all hours, whereas at one time, the only way to find out was by getting together with your friends once a week.
Even your boss has access to you, and can probably text, message, or video call you in the middle of sexy time with your spouse (the video call could be especially awkward).
There’s no point in whining and complaining though. With the negative side of all of this access and blurred boundaries, humans are accomplishing more than ever. So I’m not going to piss and moan about modern-day living. Instead, I want to address a few simple steps you can take to make your lifestyle work for you, rather than you being a victim of your lifestyle.
Sleep Seven+ Hours
If you’re going to get over adrenal fatigue and rebuild your resilience to stress, you must make sleep a consistent priority.
When you produce sufficient melatonin, which requires you to avoid excessive blue light and to go to sleep at a consistent time, you secrete growth hormone to help your body physically repair itself, and brain-derived neurotrophic factor (BDNF) which helps your brain repair itself.
Remember, adrenal fatigue is caused by an inability to physically and mentally recover from stress. Sleep is your number one tool for recovery.
Take More “Me Time” Breaks
Remember the example I used of what happens if you did deadlifts every day? You don’t allow enough time between sessions to recover from one to the next.
You do the same thing when you bounce from one event, meeting, conversation, or task to the next without taking a break.
I’m pretty deliberate about how I schedule my day, especially when I’m scheduling meetings that include other people. For many years, I went from one meeting to another, with each booked for the full hour, and most of them running over their allotted time.
Not only did I feel stressed out about mentally jumping from one topic to the next, I also felt stressed by the fact that I didn’t get a few minutes to organize my thoughts about the previous meeting, before I had to walk in late to the next one.
After a year or so of feeling like I was jumping from one hamster wheel to the next, I took responsibility for what I could.
Whenever I organize meetings, I scheduled them to start at five after the hour, so the attendees wouldn’t feel so rushed from the meeting before. I also scheduled them to end by ten to, which would give people at least ten minutes of a mental break before getting to the next meeting. Then, I tried to get the meeting done in 40 minutes or less.
It doesn’t always work as planned, but even if it runs a little over, there’s usually time for people to casually get to their next appointment.
You need small, regular blocks of time during the day to take a mental break from your professional or personal responsibilities.
You can’t jump from one mental stress to the next and expect your mind to relax when it’s time for bed. You need short mental breaks throughout the day.
You might be able to make your mental break part of this next lifestyle habit. Just put it in your calendar if you need to: Get Off Your Ass.
Interestingly, I’ve read research showing that smokers have lower stress levels. While you’d think it was something to do with the nicotine, the evidence indicated that their smoke breaks forced them to get away from work more often than non-smokers. I’m not suggesting you start smoking, but there’s something to be learned there.
Go for a walk, do a few yoga poses or some pushups, or jump on a trampoline.
Have Sex Often: Whoa! Say what? Have sex more often?
Yup. It’s odd that sex is so rarely recommended in the context of health and fitness. I realize that sex might feel like a ton of work when you’re burned out or fatigued, but it really does impact your stress response and mental health in a positive way.
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.
Some evidence indicates that when there is a major mismatch between partners’ desire, cortisol levels go up. The high desire spouse may feel stress from not “getting any,” and if the low desire spouse always gives into the high-desire spouse, that may also increase stress.
This is one of many reasons couples should discuss their sexual needs and desires as openly as their budget, raising kids, or their favorite blend of coffee.
Here’s where so many people who’d like to overcome adrenal fatigue dig the hole deeper.
They often gain weight when dealing with adrenal fatigue. They also get it stuck in their head that they have to do hours of cardio to keep from gaining more weight. Yet that very activity may compromise their resilience even more.
In the case of adrenal fatigue, excessive cardio does little, if anything, to control body fat, and does much to mess with your stress response.
The foundation for rebuilding your resilience with exercise is weight training and walking. That’s weight training and walking, not or. Yoga is fine too, in addition to the other two.
I’m not referring to Crossfit, p90X, Alpha Training, boot camp, or any other high-intensity resistance training program.
Any fitness professional who would put a client on such a program when they’re dealing with adrenal fatigue, sleep deprivation, overtraining or chronic fatigue should be fired.
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.
The goal is to provide a 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.
Just one last word of warning though…you will not rebuild your resilience if you add extra interval training, running, or other intense exercise to your program. You’ll only hold yourself back from recovering.
Walking isn’t about calorie-burning. It’s about movement. 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.
Your attitude about, or perspective of, your situation determines the amount of stress it creates.
The more you talk about “having adrenal fatigue,” the more power you give it over you. The more you use your adrenal fatigue as a reason to not participate in life, the more you believe that it hinders everything about your life.
The more you talk about your adrenal fatigue, the more emotional you’ll feel about it. Those feelings won’t serve you well, as you try to reclaim your mental and physical health. Stop talking about your situation. Start talking about and acting on your solutions.
Surround yourself with people who challenge you and encourage you to keep moving forward, and stay away from toxic people who make you feel worse.
Note: This is one of the many benefits Life Time members experience. They’re surrounded by hundreds of other people pursuing a healthier, happier life.
If the core of adrenal fatigue is a reduced resilience to stress, and good nutrition provides the vitamins, minerals, and macronutrients necessary for our bodies to recover from stress, then nutrition is uber-important.
Eat Plenty of Protein
If you read High Protein Diets: Health Benefits and Controversies, you know how essential protein is, and why so many people don’t get enough of it.
If you consistently fall short of optimal protein intake, you deprive your body of the most important macronutrient for growth and repair. Amino acids also play an important role in cognitive health and your body’s stress response.
Take the Foundational Five
Before you delve into supplements to support your adrenal health, start with The Foundational Five, the best supplements to support your health. They include:
Stress increases your use of vitamins and minerals, so don’t let a micronutrient deficit contribute to unnecessary fatigue.
Eat For Nutrition. Stop The (Carb and Calorie) Restriction
Adrenal fatigue often leads to weight gain. To avoid further weight gain, or in hopes of losing some of the extra weight, you might be tempted to cut calories or do Keto. That’s a bad idea.
Your body is already hypersensitive to stress, and adding another form of stress by restricting calories or eliminating carbs will make things worse, and won’t help you lose weight anyway.
Your priority is to rebuild your health and resilience. I understand the extra weight can be frustrating, but if you focus on that instead of restoring resilience, you’ll make your adrenal fatigue worse.
If you absolutely need a nutrition plan to follow beyond eating more protein, I recommend a Paleo diet like Whole 30 for at least six months.
If you’d like a more simple list of guidelines, here you go:
- Prioritize protein at each meal and 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, making sure they are minimally processed, and finish eating a few hours before going to sleep
It really can be that simple. Oh, and I can’t forget to mention this: Cutting coffee is not going to fix your adrenal fatigue.
If you enjoy your morning up 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. Coffee alone doesn’t cause adrenal problems, although slamming energy drinks all day long will absolutely make things worse.
Supplement To Support Your Adrenals and Rebuild Your Resilience: Provided you’re eating well and start with the Foundational Five I mentioned above, some additional supplements have been shown to help support a healthy stress response and enhance recovery and resilience.
Some of the most notable adrenal system support supplements and ingredients include:
- Adrenal Extract: Like thyroid extract, adrenal extract is often used to support adrenal health and normal stress levels.* 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 found positive effects.
- Ashwagandha: Also known as Withania somnifera. 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. Also supports muscle strength and recovery, and helps maintain healthy body composition in adults under chronic stress.*
- DHEA: 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 amortization of testosterone to estrogen.*
- Lemon Balm: Also known as Melissa officinalis, lemon balm is often recommended in the traditional health world. It’s been used for a long time, so there is plenty of anecdotal evidence for its benefits with stress. Lemon Balm has been shown to 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 most pure 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 extracts. Has been shown to help cause feelings of relaxation and modulate the body’s stress response.* May also support normal DHEA levels, especially in women.* May help maintain normal testosterone in seasons of high stress that normally cause testosterone levels to fall.*
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. You must also understand that 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. But remember the quote above: No supplement is so good that it can undo the effects of a lousy diet (or attitude or lifestyle).
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.