Tiny glands that do a big job: seated just above the kidneys are the adrenal glands. The adrenal glands produce hormones such as cortisol, aldosterone, and adrenaline which are essential for regulating our metabolism, immune system, blood pressure, and stress responses. Adrenal fatigue can occur when the glands become overworked from the release of excess cortisol, leading to symptoms such as fatigue, nervousness, and agitation[i].
Normally, the adrenal glands operate on their own and release hormones in appropriate amounts in response to external triggers, such as stress or exercise[ii]. However, these glands may malfunction or become fatigued and produce inadequate levels of hormones at the right time. This condition is known as "adrenal insufficiency" [iii][iv]or Addison's disease, and it is a recognised medical condition diagnosed through tests that measure the levels of adrenal hormones, such as cortisol[v][vi].
The situation becomes complicated when someone has an intermediate condition. This means that their adrenal hormone levels are not low enough to be diagnosed with Addison's disease, but their adrenal glands are not functioning well enough to maintain good health or well-being. This condition is typically referred to as adrenal fatigue[vii].
When a person is constantly experiencing a state of being in "fight or flight" mode and is under chronic stress, their adrenal glands produce increased levels of cortisol. This overwork can lead to a condition known as adrenal fatigue, in which the glands are unable to produce enough cortisol and aldosterone required for the body to function optimally.
In autoimmune conditions, chronic inflammation is a significant contributor to a wide range of adrenal fatigue symptoms. To combat this inflammation, it is essential to maintain healthy adrenal function and cortisol levels. If adrenals are depleted, the body has a hard time keeping up with the demand for cortisol, which weakens the immune barriers in various parts of the body, allowing harmful substances to enter and cause further inflammation. As a result, it is crucial to have proper adrenal function in order to manage autoimmunity effectively. However, chronic stress can exhaust the adrenals, making it difficult to maintain proper function.
Adrenal fatigue can produce a range of physical and psychological symptoms, including:
Fatigue and weakness
Difficulty in handling stress
Insomnia or difficulty sleeping
Weight gain or loss
Digestive issues, such as bloating, constipation, or diarrhoea
Muscle and joint pain
Reduced immune function, leading to more frequent infections
Cravings for sugar, salt, and unhealthy foods
Mood swings, anxiety, and depression
Brain fog and difficulty concentrating
If left untreated, adrenal fatigue can lead to more serious health problems, such as autoimmune diseases, thyroid disorders, and chronic fatigue syndrome[viii].
Nutritional therapists can provide guidance on appropriate treatment and lifestyle changes to manage the condition of adrenal fatigue, as well as recommending and analysing the results of functional testing to inform decisions regarding the treatment plan.
Functional Testing For Adrenal Fatigue:
Adrenal Stress Index: The Adrenal Stress Index is an easy-to-use home salivary test which evaluates adrenal function and fluctuations in the circadian rhythm. The test checks levels of cortisol and DHEA, the two steroid hormones that assist the body to manage stress.
Complete Thyroid Panel: If someone is suspected of having adrenal fatigue, a thyroid test may be advised as the adrenal and thyroid glands are linked. The levels of thyroid hormones, like T3 and T4, can indicate a low thyroid function, which is commonly seen in people with adrenal fatigue. Therefore, a thyroid test can evaluate the general health of the endocrine system and assist healthcare professionals in identifying the root cause of symptoms related to adrenal fatigue.
Complete Hormone Panel - DUTCH Test: This test is a comprehensive assessment of sex and adrenal hormones and their metabolites. It also includes the daily, free cortisol pattern, organic acids, DUTCH Complete can also help identify the root causes of hormone imbalances in men and women.
1. Avoid processed foods:
This includes excess sugar, processed carbohydrates, and industrial seed oils
Excess carbs and sugars cause blood sugar to spike, then fall rapidly and this upsets the nervous system by spiking cortisol levels because adrenals are put in a position to release extra cortisol to bring back blood glucose balance. Repeated over time, this process depletes adrenal function. Industrial seed oils cause overall inflammation in the body that depletes the adrenals as well[ix].
2. Eat regular, well-balanced meals
Not only what you eat, but when you eat has a major effect on adrenal function. Low blood sugar brought on by irregular meal timing causes the adrenals to go into emergency mode, pumping out extra cortisol to fix blood glucose imbalances. Regular meals help keep blood sugar stable, which helps the adrenals to maintain a steady function[x].
3. When you’re tired, avoid stimulants and sugar
When you get an afternoon slump, you might be tempted to grab coffee or sugary treats. That will only serve to further attack your adrenals by spiking blood sugar and driving cortisol release. Instead, nourish your body with a combination of protein, healthy fats, and minimal carbs to support healthy blood sugar and brain function, which is what you really need to kick the blahs[xi].
4. Sleep (read our article on Sleep here):
5. Quit stimulants, including caffeine:
Yes, you might have to rethink your coffee consumption. Caffeine can exacerbate the symptoms of adrenal fatigue. Caffeine and other stimulants cause the adrenals to release extra stress hormones, which done as a matter of habit, depletes the adrenals, driving you into a state of deeper exhaustion. The coffee or tea caffeine “pick-me-up” you crave is not actually that helpful, even in the mornings.
5. Exercise moderately:
Exercise is vital for good health. However, if your adrenals are struggling, rigorous exercise can be too much for them and may leave you feeling depleted. If you suspect you have adrenal fatigue, try to keep exercise moderate and stop before you get exhausted[xii].
Ensure you have adequate amounts of:
Unprocessed, lean sources of protein[xiii]
Colourful, antioxidant-rich fruits and vegetables
When it comes to adrenal health, nutrient deficiencies are often the cause of common symptoms such as stress and weight gain, irritability, and fatigue. In order to maintain adrenal health, it is important to consume certain nutrients, including vitamins C, E, and all B vitamins, especially pantothenic acid and B6. The production and actions of stress hormones rely on these vitamins. Good sources of these vitamins include red and orange fruits, colourful vegetables, avocados, hazelnuts, almonds, seeds, spinach, asparagus, brewer's yeast, sunflower seeds, wheat germ, fish (tuna, salmon, trout), liver, and beans. Additionally, magnesium is essential for providing energy to the adrenals and every cell in the body to function properly. Dark green leafy vegetables, fish, nuts, and seeds are good sources of magnesium. A comprehensive multivitamin/mineral formula such as Essential Nutrients can also be considered.
Magnesium provides necessary energy for your adrenals, also for every other cell in your body, helping everything to function properly. Magnesium is needed for hundreds of chemical reactions in the body (including regulating cortisol[xiv]), and it is noticeably reduced in the soil upon which we grow our crops.
Calcium and several trace minerals, like zinc, manganese, selenium, and iodine produce calming effects in the nervous system, which will help to restore normal cortisol levels[xv]. Vitamins C, E and all B vitamins (especially pantothenic acid and B6) have crucial roles in the production and actions of stress hormones[xvi][xvii].
Try: Pure Encapsulations O.N.E. Multivitamin – with great levels of these essential minerals and minerals and Pure Encapsulations Buffered Ascorbic Acid (vitamin C)
Dr. Schulze's Superfood (400g): provides high levels of protein as well as high levels of vitamins B6 and B12.
Cytoplan Adrenal Support: Adrenal Support comprises a blend of herbs - liquorice, ginseng (Siberian and Chinese) and Suma/Pfaffia, alongside the minerals iodine, chromium and selenium, and importantly, good levels of pantothenic acid (vitamin B5).
Living Nutrition Organic Fermented Ashwagandha: Ashwagandha is a rejuvenating tonic highly regarded in Ayurvedic medicine to restore balance and health.
Living Nutrition use the ancient art of fermentation to evolve Ashwagandha naturally into a far more vital and energetic form.
Terranova Smooth Synergy: To maintain balance through times of stress. Combining B vitamins and Magnesium with Ashwagandha, Rhodiola, magnesium and B-Vitamins.
Viridian Magnesium, B6 and Saffron: Featuring clinically studied saffron (Crocus sativus) extract with high-potency magnesium and vitamin B6 which both contribute to normal functioning of the nervous system.
Viridian Adaptogen Complex: This adaptogen complex contains Siberian ginseng, panax ginseng, mate tea, Damiana leaf and Suma root to support energy, stress and hormone levels.
A Vogel Emergency Essence Combination flower remedy: Taking this remedy will help you to feel comforted reassured, settled, supported and more courageous. Emergency Essence can be safely used alongside any of our other combination flower remedies.
Viridian L-Theanine And Lemon Balm: Theanine is a water soluble amino acid and a constituent of green tea. Combined with the soothing herb Lemon Balm, this complex is designed for use at times of heightened stress where focus is still required.
Dirtea Reishi Mushroom Powder: This pure and potent Reishi mushroom powder can enhance your immune system whilst also helping to reduce stress, centre yourself and can improve your quality of sleep.
Numerous adaptogens are widely known for their health benefits, including Ashwagandha, Siberian ginseng, Rhodiola, Schisandra, Licorice, Maca, and Holy Basil. Scientific research supports their effectiveness. Each adaptogen has a unique character, Ashwagandha and Siberian ginseng, both balance the adrenal glands but have different healing properties. While Ashwagandha has a calming and soothing effect that reduces anxiety, Siberian ginseng is more revitalizing and energising [xix][xx].
Try: Terranova Holy Basil 400mg: Holy basil can be an effective herb to help relieve stress and normalise adrenal function. Numerous studies have found that the plant offers protection against elevated cortisol, as well as glucose control [xxi].
Schisandra: Studies have discovered that Schisandra has the ability to lower cortisol levels, which is a hormone associated with stress, and can effectively regulate the fluctuations in serotonin and adrenaline caused by stress. Additionally, this adaptogenic fruit combats the exhaustion of adrenal glands that is typically associated with stress[xxii]. Try this supplement containing Schisandra: The Organic Pharmacy Liver & Kidney Drops
It is important to consume a breakfast that is high in protein and healthy fats and does not contain any added sugars or stimulants.
Even if you are not hungry, it is recommended that you eat a small breakfast to set the tone for the day.
Avoid consuming sweets and 'white carbs' before lunch to prevent blood sugar swings that can lead to an afternoon crash.
To maintain stable blood sugar levels, it is suggested that you eat every 2-3 hours and include protein and healthy fats in each meal and snack.
It is also essential to take time for yourself, relax, have fun, and engage in stress-relieving activities such as meditation or deep breathing. If you feel tired, it is important to listen to your body's signals and rest when you can.
Finally, it is important to address life stress, which can be the most difficult item on the list. Stress is omnipresent and unavoidable in life, but certain stressors can be acknowledged and removed. Take an honest overview of what is bringing you stress into your life to reveal those aspects you need to eliminate or reduce. Toxic relationships? An unsuitable job or working environment? Taking on too much in your “spare time”? Everyone has a different list - determine yours and take action to do what you can for yourself and your health.
[i] James L. Wilson, Clinical perspective on stress, cortisol and adrenal fatigue, Advances in Integrative Medicine,
Volume 1, Issue 2, 2014, Pages 93-96.
[ii] Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocr Disord. 2016 Aug 24;16(1):48. doi: 10.1186/s12902-016-0128-4. Erratum in: BMC Endocr Disord. 2016 Nov 16;16(1):63.
[iii] Hahner S, Ross RJ, Arlt W, Bancos I, Burger-Stritt S, Torpy DJ, Husebye ES, Quinkler M. Adrenal insufficiency. Nat Rev Dis Primers. 2021 Mar 11;7(1):19.
[iv] Pazderska A, Pearce SH. Adrenal insufficiency - recognition and management. Clin Med (Lond). 2017 Jun;17(3):258-262. doi: 10.7861/clinmedicine.17-3-258.
[v] L.A. Trevino, M.L. Uhelski, A.L. Dougall, A. Baum,
Editor(s): V.S. Ramachandran,
Encyclopedia of Human Behavior (Second Edition),
[vi] Ross IL, Jones J, Blockman M. We are tired of 'adrenal fatigue'. S Afr Med J. 2018 Aug 28;108(9):724-725.
[vii] H. Maurice Goodman, Chapter 4 - Adrenal Glands, Editor(s): H. Maurice Goodman, Basic Medical Endocrinology (Fourth Edition), Academic Press, 2009.
[viii] Sapra A, Bhandari P. Chronic Fatigue Syndrome. 2022 Jul 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491608.
[ix] Lakhan SE, Kirchgessner A. Gut inflammation in chronic fatigue syndrome. Nutr Metab (Lond). 2010;7:79. Published 2010 Oct 12. doi:10.1186/1743-7075-7-79
[x] Paoli A, Tinsley G, Bianco A, Moro T. The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting. Nutrients. 2019;11(4):719. Published 2019 Mar 28. doi:10.3390/nu11040719
[xi] Lovallo WR, Whitsett TL, al'Absi M, Sung BH, Vincent AS, Wilson MF. Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels. Psychosom Med. 2005 Sep-Oct;67(5):734-9.
[xii] De Nys L, Anderson K, Ofosu EF, Ryde GC, Connelly J, Whittaker AC. The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology. 2022 Sep;143:105843. doi: 10.1016/j.psyneuen.2022.105843.
[xiii] Lemmens SG, Born JM, Martens EA, Martens MJ, Westerterp-Plantenga MS. Influence of consumption of a high-protein vs. high-carbohydrate meal on the physiological cortisol and psychological mood response in men and women. PLoS One. 2011;6(2):e16826. Published 2011 Feb 3. doi:10.1371/journal.pone.0016826
[xiv] Schutten JC, Joris PJ, Minović I, et al. Long-term magnesium supplementation improves glucocorticoid metabolism: A post-hoc analysis of an intervention trial. Clin Endocrinol (Oxf). 2021;94(2):150-157. doi:10.1111/cen.14350
[xv] Alves J, Barrientos G, Toro V, Grijota FJ, Muñoz D, Maynar M. Correlations between Basal Trace Minerals and Hormones in Middle and Long-Distance High-Level Male Runners. Int J Environ Res Public Health. 2020 Dec 17;17(24):9473.
[xvi] Camfield DA, Wetherell MA, Scholey AB, et al. The effects of multivitamin supplementation on diurnal cortisol secretion and perceived stress. Nutrients. 2013;5(11):4429-4450. Published 2013 Nov 11. doi:10.3390/nu5114429
[xvii] Bettina Moritz, Ariana E. Schmitz, Ana Lúcia S. Rodrigues, Alcir L. Dafre, Mauricio P. Cunha,
The role of vitamin C in stress-related disorders, The Journal of Nutritional Biochemistry, Volume 85,2020,108459,ISSN 0955-2863,
[xviii] Panossian A, Hambardzumyan M, Hovhanissyan A, Wikman G. The adaptogens rhodiola and schizandra modify the response to immobilization stress in rabbits by suppressing the increase of phosphorylated stress-activated protein kinase, nitric oxide and cortisol. Drug Target Insights. 2007;2:39-54.
[xix] Arring NM, Millstine D, Marks LA, Nail LM. Ginseng as a Treatment for Fatigue: A Systematic Review. J Altern Complement Med. 2018 Jul;24(7):624-633.
[xx] Fry, C.H., Fluck, D. & Han, T.S. Adrenal hypofunction associated with ashwagandha (Withania somnifera) supplementation: a case report. Toxicol. Environ. Health Sci. 14, 141–145 (2022). https://doi.org/10.1007/s13530...
[xxi] Lopresti AL, Smith SJ, Metse AP, Drummond PD. A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum(Holy Basil) extract (HolixerTM) on stress, mood, and sleep in adults experiencing stress. Front Nutr. 2022;9:965130. Published 2022 Sep 2. doi:10.3389/fnut.2022.965130
[xxii] Panossian A, Hambardzumyan M, Hovhanissyan A, Wikman G. The adaptogens rhodiola and schizandra modify the response to immobilization stress in rabbits by suppressing the increase of phosphorylated stress-activated protein kinase, nitric oxide and cortisol. Drug Target Insights. 2007;2:39-54.
Please note that the information contained within this website does not and should not replace medical advice, and is not intended to treat or diagnose. We always recommend you consult with your doctor. Our Nutritional Therapy team is highly trained and we offer one to one Nutritional Therapy Consultations, which are designed to be complementary to any medical treatment from a functional medicine approach, as well as offering a preventative & optimal health focus.