Early Adrenal Fatigue


The adrenal glands secrete cortisol, epinephrine, DHEA, progesterone and testosterone.

They are small glands that are located just above the kidneys.

They are responsible for:

Energy production, through carbohydrate conversion to blood glucose for energy.

Fluid and electrolyte balance.

Fat Storage

Fight or flight response.


Cortisol produced by the adrenal gland:

Regulates blood sugar.

Regulates blood pressure and electrolyte balance.

Helps to regulate the immune system.

Elevated cortisol levels weaken the immune system.

Low cortisol levels increase the risk of autoimmune disease.


Continued stress on the adrenal glands, through life stressors, may lead to dysfunction or “fatigue”.

Adrenal fatigue is more common and increasingly recognized due to lifestyle factors such as constant stress, lack of sleep, lack of relaxation, poor eating habits, environmental toxins, allergens, caffeine and smoking.


Symptoms of adrenal fatigue may include:

Difficulty awakening from sleep in the morning

Requiring coffee in the morning in order to approach the day

Increased weight with increased waist circumference

Lower immunity to colds or flu viruses

Difficulty dealing with stress

Drop in libido

Lightheadedness on standing quickly

Poor memory or “brain fog”

Feeling of being tired in the morning, or between 3 to 5pm

Feeling the need to snack

Feeling tired in the mornings and afternoons between 3-5pm

Feeling tired between 7 to 10pm, and surge of energy later in the evening

Craving salty foods

Premenstrual syndrome, moodiness and fatigue

Pain in upper back and/or neck without identifiable cause

Improvement in symptoms above when on vacation

Mild depression or anxiety

Multiple allergies

General lethargy and lack of energy (more advanced stages)

Increased effort to perform daily tasks

Decreased ability to handle stress

Dry and thin skin

Low blood sugar

Low body temperature


Unexplained hair loss

Alternating diarrhea or constipation

Food intolerances


Stage II Adrenal Fatigue

Hormones are produced as required to respond to life and body stressors, however DHEA and other sex hormones begin to drop in stage II adrenal fatigue. This is because precursors to sex hormones are being used in priority to produce cortisol and other necessary stress hormones in the adrenal gland.


A common feeling may be described as “wired but tired”, maintenance of alertness during the day but extreme fatigue in the evening.

The body may need more rest to recover from the day. Anxiety and irritability may increase.

Insomnia may be more common.

Infections may be more common.

Premenstrual syndrome symptoms may be more common.

Symptoms of hypothyroidism, such as feeling cold, sluggish, slow metabolism, central weight gain despite exercise are more common.


At this stage thyroid replacement as well as progesterone or estrogen may be prescribed, but may not be effective. Antidepressants, or stimulants may be prescribed and also have limited effectiveness.

Metabolic syndrome can develop, along with hypoglycemia and glucose intolerance.

In stage 1 and 2 adrenal fatigue, cortisol is elevated and results in elevated glucose. As adrenal dysfuntion continues and the cortisol levels are dropping off, the blood glucose levels fall. Dysregulation occurs as cortisol levels are dropping and insulin levels are increased, leading to hypoglycemia. This hypoglycemia then leads to proteins and fats of the body being used as energy sources.

The liver clears alcohol, pesticides, herbicides and food additives.

As the liver is compromised, toxins can accumulate in the body.

This may lead to “brain fog”, joint pain, anxiety, depression, fatigue, muscle pain, neurologic symptoms such as abnormal reflexes and tingling of hands.

In this phase of adrenal fatigue unclear thinking, concentration problems, anxiety, food allergies, chemical sensitivities, food intolerances, pain of unknown origin, yeast infections, irritable bowel, interstitial cystitis may develop.

Detoxification regimens may be undertaken, with limited success.

The chronic pain that may develop with adrenal fatigue unchecked, may lead to the diagnosis of fibromyalgia, and /or chronic fatigue.


Chronically elevated cortisol levels, can lead to a state of catabolism or breakdown of proteins.

Loss of muscle mass can occur.

Advanced adrenal dysfunction can lead to breakdown of collagen, and therefore breakdown of skin and gut. This can lead to constipation, irritable bowel syndrome.

Support of the GI tract may be achieved through digestive enzymes and hydrolyzed collagen.


Neurologic dysfunction may be manifested as insomnia, brain fog, anxiety and tremors.

Inappropriate cortisol levels, either high or low, may lead to sleep disturbances.

Waking between 1am and 3am may be an indicator of glucose levels that are too low during sleep.

Low glucose levels may also lead to heart palpitations, anxiety attacks and sweats.


Lack of restorative sleep can lead to additional adrenal dysfunction.

Lack of restorative sleep can lead to decreased immunity, glucose intolerance, decreased morning cortisol levels, increased estrogen levels, decreased alertness and concentration.

Brain fog usually resolves, after the adrenal dysfunction improves.


Detoxification strategies may lead to more stress in the adrenals and then worsening symptoms.

Nutritional supplements that are meant to enhance liver function, can make symptoms worse.

Hormone imbalances may result.

Estrogen dominant issues may arise such as: PMS, PCOS, cystic breast disease, and irregular periods.


Estrogen can increase thyroid binding proteins, and may lead to sub-clinical hypothyroidism.

Elevated estrogen levels may alter the release of cortisol from the adrenal glands.

Elevated estrogen levels can increase cortisol binding globulin, and thus inadequate levels of free cortisol.

Estrogen dominance can lead to adrenal dysfunction.

Adrenal dysfunction can lead to estrogen dominance. Cortisol is made in the adrenal cortex from progesterone. If the adrenals are not working well, progesterone is sacrificed in order to support cortisol production. Estrogen dominance ensues and forms a cycle.


Excessive estrogen affects not only the adrenals, but also the thyroid function.

Thyroid dysfunction ensues from adrenal dysfunction that is refractory to thyroid hormone replacement.

Thyroid binding globulin is increased, this leads to lower levels of the thyroid hormones free T3 and free T4. T4 to T3 conversion is also decreased. Adrenal dysfunction can also lead to more reverse T3, thus slowing down metabolism by binding thyroid receptors.


Androgen imbalance may result from adrenal dysfunction.

In women this may lead to: seborrhea, acne, hirsuitism, hair loss.

Aconathosis nigrans can develop from elevated insulin levels.

Libido is lowered.

Immune system dysfunction can result from adrenal dysfunction. Auto-immune responses can evolve.

Susceptibility to infections can develop.

Dysbiosis can develop.

Systemic candidiasis can develop.

Interstitial cystitis can develop.


Aldosterone levels may be affected leading to salt craving and low blood pressure. This is usually pronounced in more advanced stages of adrenal fatigue.


Eat well.

What you eat matters. Eat healthy foods at regular intervals. Since cortisol helps regulate blood sugar, keeping glucose levels balanced will take some of the stress off the adrenal glands. Three nutritious meals and two healthy snacks spread out across the day will keep our adrenal glands steady.

When you eat matters. Our natural circadian rhythms can help us know when our bodies need nourishment and fuel. Cortisol’s cycle complements our body’s own rhythms, although highest in the morning and declines gradually throughout the day. When we eat we elevate our cortisol, so it’s ideal to consume larger meals earlier in the day, which also helps our body prepare itself for restful sleep at night.

Have healthy foods on hand. It may be easy to reach for sweets and caffeine for quick energy, but these actually backfire on us, dropping our blood sugar levels rapidly. Reaching for micronutrient-rich foods, such as lean protein, avocado, fresh fruits and vegetables, garlic, and ginger will more adequately support adrenal functioning.


Food that stress the adrenals to remove:


Caffeine (if you require caffeine – drink before noon)

Saugar and artificial sweeteners

Processed foods and microwavable foods

Hydrogenated oils (soybean, canola and corn oils are inflammatory and should be avoided, substitute with coconut oil, olive oil, organic butter or ghee).


Foods to add:


Olives Avocado

Cruciferous vegetables (cauliflower, broccoli, Brussel sprouts)

Fatty fish



Nuts: walnuts and almonds

Seeds: pumpkin, chia, flax



Calories should come from: 1/3 clean protein. 1/3 healthy fats, 1/3 low glycemic carbohydrates (fruits and vegetables)



Bad fats and replace with good fats.

Remove: Bad fats such as hydrogenated and partially hydrogenated oils, trans fats, soybean oil, canola oil and vegetable oils

Add: Good fats.

Remove: Bad meats. Grain fed animals have a differing fat composition than those which are grass fed. Pesticides may also accumulate in the muscle. Grass fed animals contain better fats.

Remove: Refined gars and grains (white rice, pasta, and bread)

Add: Low glycemic carbohydrates (fruits and vegetables)


Pace yourself.

Our fast-paced world is never unplugged. We rarely have time to disconnect from technology.

When stress levels are high and our adrenals are working overtime, we will stay in a perpetuating cycle of adding pounds.

Sleep. An upside down circadian rhythm affects cortisol levels, causing irregular sleep patterns. You can correct these by eating less food late in the day, turning off all technology including television, by 8 p.m., and by trying to be in bed and asleep by 10 p.m. The goal is to have at least eight hours of sleep, so our bodies can rest and regulate our hormonal cycles.



Our adrenals respond to stress, even if we think it is positive. Exercise is positive, and can help us reduce stress, but only if it does not make us feel tired. When we are exhausted, our adrenals are already working hard, and exercise can put added strain on them. The goal is to keep your heart rate under 90 beats per minute when working out. If you don’t regularly exercise, walking 15 minutes once or twice a day after meals helps to support adrenal function.


Be mindful.

When we live with continually elevated levels of stress, our body adjusts to the “crisis mode” and sometimes needs help learning how to live in a calmer state. The first step is to heal your adrenals. Meditation and paced breathing can be helpful. Have fun. Don’t forget that having fun, laughing, and enjoying your time is a very important way to relax.


Supplement Support

Ashwaganda – Douglas Labs


Holy Basil


Fish Oil




Vitamin B5


Vitamin B12


Vitamin C


Vitamin D3