Adrenal fatigue and stress
Eating to boost your adrenal health
Reviewed by Dr. Mary James, ND
Fatigue is one of the most common symptoms we hear about. And when we ask these
women to tell us about what's going on in their lives, all too often the answers
reveal they have more responsibility in their lives than seems humanly possible
They're waking up still tired and unable to think straight in the morning without
caffeine; needing high-carb snacks, additional caffeine, or naps to get through
the afternoon, then burning the midnight oil because they're too wired at this point
to sleep. Alcohol or sleep aids are sometimes used to unwind, which can disrupt
normal sleep patterns, setting them up for non-refreshing sleep. Pretty soon they're
caught in a seemingly unending cycle of exhaustion and poor nutrition, desperate
for the energy they once had.
How chronic stress affects the adrenal glands
Science tells us that if you experience stress on a chronic basis, the tiny adrenal
glands that moderate your stress response and keep many other hormones balanced
will suffer. The stress response — when the adrenals produce the hormone cortisol
— is normal. We need cortisol to handle emergencies. However, the stress response
is designed to be short-term, with a fairly quick return to a relaxed baseline.
Unfortunately, our adrenals don't know the difference between a true emergency and
the stress from merely sitting in a traffic jam. Many of us stay revved up all day
in a ‘fight-or-flight' state. But when cortisol stays elevated like that, our bodies
gradually become less sensitive to the mechanism that helps bring it back to normal.
The consequences of high cortisol
Chronically high cortisol interferes with digestion, immune function, sleep, and
the body's ability to produce other essential hormones, such as DHEA, testosterone,
estrogen, progesterone, and thyroid hormone. Over time, unrelenting cortisol production
can contribute to excess abdominal fat, high blood pressure, high blood sugar, and
aches and pains from too much inflammation. It demands too much from the adrenal
glands and affects DHEA production, which in turn compromises bone health, immunity,
mood, and sex drive.
As the adrenal glands become increasingly compromised, it's harder for them to make
cortisol. Instead, extra adrenalin is produced to compensate, which can make us
irritable and shaky. Adrenal fatigue can cause low blood sugar, anxiety, inability
to concentrate, lightheadedness on standing, allergies, and low blood pressure.
Now we are on our way to pure exhaustion.
On the upside, adrenal dysfunction can be healed. Although stress management (both
decreasing your stress load and adjusting your emotional response to stressors)
is the most important step in reversing adrenal fatigue, changing what
you eat, when you eat, and how you eat can make a dramatic difference.
Let's look at some easy dietary approaches for supporting your adrenals — so you
can enjoy good energy all through the day, and get a great night's sleep.
First and foremost: timing your meals and snacks
One thing we often tell women is to never allow themselves to get too hungry. Low
blood sugar alone produces a stress reaction in the body and can tax the adrenals.
You may not realize that your body is in constant need of energy — even as you sleep.
And because cortisol is the primary adrenal hormone, it serves as a kind of moderator
in making sure your blood sugar between meals, especially during the night,
Long periods without food make the adrenals work harder by requiring them to release
more cortisol and adrenalin to keep your body functioning normally. Eating three
nutritious meals and two to three snacks throughout the day is one way to balance
blood sugar and lessen the adrenal burden.
When you eat your meals and snacks can make a big difference. As you can
see in the graph, cortisol follows a natural cycle that works with your circadian
rhythm. Normally, it begins to rise around 6:00 AM and reaches its highest peak
around 8:00 AM. Throughout the day, cortisol gradually and naturally declines —
with small upward bumps at meal times — to prepare your body for nighttime rest.
That's why cortisol is normally at its lowest level during the night.
Ideally, you want to work with this natural cycle to keep the tapering-off of levels
as smooth as possible as the day progresses, and to avoid dramatic ups and downs.
Eating the majority of your food earlier in the day can help accomplish this, so
can eating an early dinner (by 5:00 or 6:00 PM). If it's difficult for you to eat
early, you can at least try to make your evening meal the lightest one of the day.
Many women tell us they overeat at dinner and before bed to soothe themselves in
the evening. But if our cortisol levels are still high at this time, we'll be attracted
to foods that are high in sugar and fat. Unfortunately, this “night-eating” habit
usually can further upset our hormone balance.
Keep in mind that cortisol will also rise a bit with exercise. Lighter activities,
such as a walk after dinner or some gentle stretching, will not interrupt this natural
tapering-off process. But to work in concert with your body's natural cortisol cycle,
more intense exercise is best planned for the morning or early afternoon.
But I’m not hungry in the morning...
As your mother probably told you, breakfast is important. But maybe you don’t
feel hungry in the morning, and if so, it could be for the following reasons:
- Corticotrophin-releasing hormone (CRH), which has appetite-dulling effects,
begins to enter the bloodstream at a fast rate first thing in the morning.
- Decreased liver function, which can accompany adrenal dysfunction or a heavy toxic
burden, can also dampen morning hunger.
Even if you don’t feel hungry, having a nutritious breakfast within an hour
of rising — preferably with protein — will provide energetic benefits
to your metabolism and cortisol levels that last throughout the day.
Here are some simple tips for the timing of meals and snacks, which can help support
your body's natural cortisol cycle:
- If possible, eat breakfast by 8:00 AM or within an hour of getting up (earlier is
better), to restore blood sugar levels after your body has been relying on glycogen
stores for energy during the night.
- Eat a nutritious snack around 9:00AM, to soften the natural dip in cortisol in late
- Try to eat lunch between 11:00 AM and 12:00 noon because your morning meal can be
used up quickly.
- Eat a nutritious snack between 2:00 and 3:00 PM to get you through the natural dip
in cortisol around 3:00 or 4:00 in the afternoon.
- Make an effort to eat dinner around 5:00 or 6:00 PM, and make this your lightest
meal of the day.
- Finally, eat a light and nutritious snack about an hour before bed. This should
ideally include some carbohydrate to help with sleep, perhaps some cheese or nut
butter with fresh fruit — avoid refined sugar carbs.
Supporting your body's natural rhythms by properly timing meals to prevent dramatic
dips in blood sugar has lots of benefits: it minimizes cortisol output and frees
up your adrenals to perform their secondary functions, and also gives you more sustained
energy throughout the day. Life becomes much more enjoyable when you have the energy
Eat, drink, and support adrenal gland function
As our awareness increases about when we eat, it's also helpful to think
more about what we eat. Stress often brings out the worst in our food choices. Women
with adrenal fatigue tell us they reach for foods and drinks that give them instant
energy — cookies, cakes, doughnuts, white bread, coffee, or soda. Craving sweets
makes sense — it's the body's normal response to low blood sugar.
Unfortunately, the surge of energy you get from consuming these foods is followed
by an even greater dip in energy, causing you to feel worse. Sugar and simple carbohydrates
stimulate a spike in blood sugar and a subsequent spike in insulin that clears sugar
from our bloodstream so fast that we “crash.” Complex carbohydrates don't cause
this same spike and crash, though too many carbs in general can still imbalance
We often suggest a gluten-free diet and limited caffeine for women with symptoms
of adrenal imbalance. Many women don't realize that caffeine can over-stimulate
the adrenals and affect sleep patterns.
If you find yourself craving caffeine or refined carbohydrates, it may be that your
cortisol or blood sugar is low or that your serotonin is imbalanced. In any case,
you may not have much energy and your body probably needs a rest. I encourage you
to honor your body's request and take a break, instead of cranking it up another
notch. Treat yourself to some deep breathing or a ten–minute walk. And if drinking
a cup of coffee is a relaxing part of your routine, drink it in the morning along
with something nutritious to eat, and add cream to help dull the negative effects
Choosing adrenal-healthy beverages
Just as with food, your choices about drinks can either support or strain your adrenal
glands. Here are some not-so-good choices and some healthy alternatives.
- Drinks that contain caffeine
- Ginseng [Panax sp.]
- Eleuthero/Siberian ginseng [Eleutherococcus senticosus] (in the morning)
- Herbal teas like chamomile, passionflower, valerian
- Vegetable juice (with salt), like V-8
Try, in general, to eat meals and snacks made of fresh whole foods, preferably organic
or locally grown, without colors, dyes, chemicals, preservatives or added hormones.
Including some protein in all of your meals and snacks (especially in the morning)
will have a stabilizing effect on your blood sugar, which, in turn, can help you
overcome cravings for caffeine and sugars. No longer will it be an issue of will
power. (For more information on eating balanced meals, see our
To lessen the stress that's often associated with making dietary changes, consider
preparing additional servings of nutritious foods on the weekends so you have them
ready and available on busy weeknights, or stop at a health food store to pick up
some hot prepared food. Don't feel guilty if you veer off the nutritious path occasionally.
Bingeing, especially on sugar, can often lead to feelings of guilt or self-disappointment,
making you want to throw your hands up and surrender. But don't worry. Eat your
best 90% of the time and the other 10% is up to you because guilt is the last thing
your adrenals need!
Salt and adrenal imbalance
Women with adrenal fatigue often crave salt — and many women should give in to this
craving. Yes, salt can increase blood pressure, but low blood pressure (hypotension)
is a very common sign of adrenal insufficiency. If you feel lightheaded when you
get out of bed in the morning, stand up quickly, or get up out of a bath or hot
tub, you may very well have low adrenal function, so including more salt in your
diet could be helpful. But try to make it good-quality sea salt.
Salt cravings in people with adrenal insufficiency are mostly due to low levels
of aldosterone, a steroid hormone that, like cortisol, is produced by the adrenal
cortex. Aldosterone is part of the complex mechanism that regulates blood pressure
in the body, partly by helping the body to hang on to salt and water. Levels of
aldosterone go up and down in a similar diurnal (daily) pattern as cortisol, and
also are influenced by stress. Generally speaking, when cortisol goes up, aldosterone
goes down, lowering blood pressure. If cortisol levels stay high, or if your adrenal
glands run out of steam, chronically low aldosterone can disturb both electrolyte
balance and cell hydration. Increasing your salt intake is one way to help restore
A nutrient-rich foundation — essential for healing adrenal imbalance
If you decide to do nothing else for your adrenals, provide your body with a strong
nutrient base. The vitamins, minerals and other micronutrients available in a pharmaceutical-grade
supplement like the one in our Adrenal Health
Package are absolutely essential for healing and reversing adrenal fatigue
— as well as for the everyday workings of your adrenal glands.
If you need additional support for adrenal health
Our Essential Nutrients provide an optimal nutritional foundation for your adrenal
health. Some women will still need extra nutritional and/or herbal support for healing
adrenal imbalance. Several key herbs that support adrenal function are called ‘adaptogens'
because they can adapt to the needs of your body, nourishing and strengthening the
adrenals, whether they're over- or underactive. Here are our top recommendations
for adaptogenic herbs and key nutrients:
- Ashwagandha (Withania somnifera)
- Eleuthero / Siberian ginseng (Eleutherococcus senticosus)
- Astragalus root (Astragalus membranaceus)
- Schisandra (Schisandra chinensis)
- Rhodiola rosea
- Licorice root (Glycyrrhiza glabra)
- Extra B vitamins (B-complex)
You can begin on your own with B vitamins and the first two herbs listed above.
If you do not notice improvement within a few weeks, consult a functional medicine
or naturopathic practitioner to create a program that best fits your personal needs
— dosage, timing, blood pressure, and cortisol levels are some of the factors that
should be taken in to consideration.
Vitamins like C, E and all the B vitamins (especially pantothenic acid and B6) have
crucial roles in the production and actions of stress hormones. And a mineral like
magnesium provides necessary energy for your adrenals — and every cell in your body
— to function properly. Calcium and several trace minerals, like zinc, manganese,
selenium, and iodine, provide calming effects in the body. These minerals can help
relieve the stress associated with adrenal fatigue and imbalance, which will ultimately
restore normal cortisol output.
A strong nutrient foundation also supports the endocrine system overall. There is
great synergy between the different organs of the endocrine system, including the
adrenal glands. And when hormonal levels become deficient or excessive, our cells
count on extra nutritional support to compensate.
Small things, dramatic differences
Your adrenal glands are tiny in comparison to many other organs — each is roughly
the size of a walnut — yet they have enormous responsibilities in your body. When
they are functioning properly, these small glands help you feel energized when you
need to be and relaxed when it is time for rest. They produce cortisol and DHEA,
and contribute to the production of estrogen, testosterone, progesterone, and so
much more. But life's demands can slowly drain the balancing power of the adrenal
glands. Even the healthiest person's adrenals become impaired under chronic, unrelenting
You have the power to lessen the burden on your adrenals — and your whole body.
It doesn't take much. The small choices you make in regards to your nutrition and
eating patterns will make a big difference. Here's our advice to you: in addition
to exploring stress management, support your body with a high quality nutritional
supplement and eat good food in harmony with your own natural daily rhythms. Soon
you'll find the energy you thought was lost — and it will be here to stay!
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Last Modified Date: 07/17/2012