3 Steps to Overcome Adrenal Fatigue

September 20, 2017
Adrenal fatigue - Dr. Axe

It’s time to do something about adrenal fatigue because chances are you’re dealing with it. (Or will at some point of your life.) Many proponents of this condition estimate that almost every person can experience adrenal fatigue, also known as hypoadrenia, to some degree at a particularly stressful point in his or her life.

According to James Wilson (author of “Adrenal Fatigue: The 21st Century Stress Syndrome”), chronic stress and lifestyle affect the body’s ability to recuperate from physical, mental or emotional stress.

Because of the vast influence of the adrenals on the body, symptoms of adrenal fatigue can mimic a number of disorders and isn’t always easily recognizable. Most sources agree that adrenal fatigue symptoms include extreme fatigue, brain fog, weight gain, insulin resistance and others (more on that below). While the mere fact you feel fatigued is not necessarily indicative of adrenal fatigue, and adrenal fatigue tests aren’t always straightforward, there is evidence that high cortisol levels found in saliva are associated with reduced immune function, increased blood pressure, increased heart rate and delayed growth in children. (1)

These symptoms and more can be indicative of a few different disorders and are often overlooked by doctors, but more and more people are starting to realize that a combination of these could indicate the onset of adrenal fatigue.

Some people at high risk for the symptoms of adrenal fatigue include busy new parents, students in college or post-graduate studies and caregivers, such as nurses or family members caring for invalid relatives.

If you have adrenal fatigue, it can also be a major cause of excess fat storage and low energy levels. Luckily, you can heal adrenal fatigue with three simple steps: start an adrenal fatigue diet, take supplements and reduce stress. So, let’s talk about exactly what your adrenal glands do and how you can overcome adrenal fatigue in these three simple steps.


What Is Adrenal Fatigue?

A relatively new term, “adrenal fatigue” was proposed as a new condition in 1998 by Dr. James L. Wilson, a naturopath and chiropractor. His assumption was that an overstimulation of the adrenal glands (or “adrenals”) by chronic stress over time could lead to an inconsistent level of cortisol (the stress hormone) in the bloodstream, sometimes far more than normal and at other times, far too low. In addition to this overload or improper cortisol level, people with adrenal fatigue often don’t have enough DHEA, the “parent hormone” responsible for the creation of many necessary hormones in the body.

Unlike other endocrine disorders that are caused by physical damage to parts of the adrenal glands, hypoadrenia is seen by many in the natural health world as a “middle ground” syndrome with simple and easy-to-implement solutions. Currently, no official diagnosis exists for adrenal fatigue and people are either considered to have normal endocrine function or total endocrine failure, like that seen in Cushing’s syndrome or adrenal insufficiency/Addison’s disease. Some postulate that this occurred in the 1950s when doctors over-prescribed adrenal steroids and saw dire consequences, leading to an overcorrection and generalization of endocrine issues. (2)

Dr. Wilson describes the unique progression of adrenal fatigue throughout the day as follows: you wake up and are unable to function without a significant amount of caffeine, finally feel a boost of energy during the early part of the day, then your energy levels crash around 2 p.m., rise around 6 p.m., fall again around 9 p.m. and then finally peak again at 11 in the evening. (3)

Is adrenal fatigue real?

As you can see, this presents a number of issues, namely, the inability to distinguish this pattern and its resulting symptoms from other disorders. Wilson’s parameters for this condition are nonspecific which, unfortunately, has led to a great controversy around this topic, even though the very nature of cortisol and bodily hormones is that their effects are far-reaching.

Indeed, an article from a São Paulo university was released in 2016 with the title: “Adrenal fatigue does not exist: a systematic review.” According to this review, results of acceptable studies available to them at the time had “conflicting results” and could provide no definitive proof of the disease, nor diagnostic criteria or adrenal fatigue treatment. (4)

While this may be discouraging to some, one issue I have with this assessment is that the main issue seemed to be study design, rather than hard results. The failure of scientists to conduct adequate tests does not immediate equate to the falsity of adrenal fatigue as a whole. In addition, a diagnosis for this condition is difficult because these cortisol levels fall in what conventional medicine would call “inside the normal range,” although the symptoms are clear to those suffering from the condition. Lastly, treatment for adrenal fatigue consists mainly of diet and lifestyle adjustments, which traditional doctors do not see as legitimate medicine. (That’s okay; we know that food is medicine, no matter how often the medical community fails to recognize this fact.)

Regardless, this topic remains a heated one in the medical community. The Hormone Health Network released a scathing piece on the issue of adrenal fatigue, essentially warning patients that it is a false diagnosis, peddled by those who profit from the “expensive” treatment methods they suggest when diagnosing the disease, with no thought for the serious dangers they may put someone in by telling them adrenal fatigue is their problem.  They also (incorrectly) remind people that supplements aren’t regulated by the FDA. (5)

Actually, the FDA closely monitors producers of dietary supplements, ensuring they make no false claims about their products, have the scientific evidence to back up the claims they do make and are properly labeling the exact ingredients included in each supplement. But that’s a discussion for a different day.

Another oft-quoted piece of evidence against the existence of adrenal fatigue is Todd B. Nippoldt’s interview with Mayo Clinic, stating essentially the same concerns. (6) Again, it is stated that consistent levels of chronic stress have no effect whatsoever on the adrenals and the only true endocrine disorders are those caused by other diseases and direct damage to the adrenal glands.

To that, all I can say is that adrenal fatigue is something I’ve seen personally. It is my opinion, through years of healthcare practice and supporting scientific evidence, that hypoadrenia is very real and associated with a number of complications. In addition, adrenal fatigue treatment is relatively non-invasive and is beneficial to your health, no matter the diagnosis. Of course, you should be under the care of a qualified medical professional, such as a functional medicine doctor, you trust and see them about any symptoms you experience (of any disease) so that they can determine appropriate treatment.

 

What is adrenal fatigue? - Dr. Axe

What Are Your Adrenal Glands?

adrenal glands above kidneysWhat are your adrenals? Your adrenal glands (adrenals) are two thumb-sized organs that sit above your kidneys and are part of the endocrine system. Also known as the suprarenal glands, they’re involved in producing over 50 hormones that drive almost every bodily function, many of which are essential for life.

Hormones affect every function, organ and tissue in the body directly or indirectly. They react to each other as well as respond to conditions in the body in an intricate and highly sensitive balancing act. The adrenal glands work closely with the hypothalamus and the pituitary gland in a system known as the hypothalamus-pituitary-adrenal axis (HPA axis). (7)

Normally, the adrenal glands release cortisol on a diurnal rhythm, referring to the process of boosts of cortisol throughout the day that help wake us up, with a decline in this hormone level in the evening to aid the body in sleeping. This rhythm, however, doesn’t always apply when external stress occurs.

Adrenal glands play a huge role in stress response. Your brain registers a threat, whether emotional, mental or physical. The adrenal medulla releases cortisol and adrenaline hormones to help you react to the threat (the fight-or-flight response), rushing blood to your brain, heart and muscles. The adrenal cortex then releases corticosteroids to dampen processes like digestion, immune system response and other functions not necessary for immediate survival.

Your adrenal glands are also responsible for balancing hormones, such as:

Glucocorticoids – hormones that balance your body’s blood sugar, help with energy and food metabolism, help your body relieve stress and manage your immune response (e.g., cortisol).

Mineralocorticoids – hormones that maintain healthy blood pressure, manage your blood hydration level, and keep your blood healthy by keeping salt and water in balance (e.g., aldosterone).

Sex hormones – estrogen and testosterone.

Adrenaline/epinephrine – hormones that affect your heart health, make sure that all parts of the body are getting blood and convert glycogen into glucose in your liver.


What Causes Adrenal Fatigue?

Adrenal fatigue is a condition where your body and adrenal glands can’t keep up with the tremendous amount of daily stress many people experience. Sometimes misunderstood as an autoimmune disorder, adrenal fatigue can mimic some precursors to other common illnesses and disease.

Wellness doctors and practitioners believe that an episode of acute stress or prolonged, chronic stress can cause adrenal glands to become overloaded and ineffective, then improperly release cortisol. They believe that hypoadrenia can be caused by:

  • Stressful experiences like death of loved one, divorce or surgery
  • Exposure to environmental toxins and pollution
  • Prolonged stress due to financial hardship, bad relationships or work environment, and other conditions that entail feelings of helplessness
  • Negative thinking and emotional trauma
  • Lack of sleep
  • Poor diet (including crash diets and inconsistent nutrition) and lack of exercise
  • Pain (8)
  • Food sensitivities
  • Surgery
  • Reliance on stimulants like caffeine or energy drinks
  • Rheumatoid arthritis (9)

But can stress cause extreme fatigue? Yes, it absolutely can. One study found that students undergoing chronic, long-term stress when prepping for medical exams at the end of their educational careers impaired the students’ cortisol awakening response. (10) By limiting this surge in cortisol that naturally occurs every morning when you wake up to help you feel alert, stress inhibits your ability to wake up fully, no matter how much sleep you get.

Another study, released in 2005, found that students diagnosed with chronic fatigue syndrome had “alterations in adrenal function,” particularly in females, suggesting that their adrenal glands were no longer receiving a normal amount of stimulation. (11) And it’s not just about the amount of sleep you get — researchers at Brandeis University discovered that the quality, rather than the quantity of sleep, affects the body’s normal cortisol responses when exposed to stress. (12)

Depression may also play a role in the development or effects of adrenal fatigue. After a major depressive episode, cortisol responses do not easily readjust to normal levels and might be somewhat responsible for a recurrence of depression. (13)

Patients with diabetes symptoms might be at increased risk for adrenal fatigue. Research from the University of Delhi found that diabetes patients “display significantly higher chronic stress and stress responses when compared to subjects with [normal glucose tolerance].” (14) This suggests that impaired glucose tolerance might have a connection with taxing of the adrenal glands.

Scientists in China have designed a cohort study to examine the interaction of genetics, biomarkers and environmental exposures with health metrics lead to chronic diseases. A validated questionnaire, along with a large battery of tests, has led them to develop a classification referred to as “suboptimal health.” This phase is essentially a step between optimal health and diagnosable illness or disease characterized by “the perception of health complaints, general weakness, chronic fatigue and low energy levels.”

It is the observation of these scientists that suboptimal health, as an “in-between” status before disease, is a precursor to many health conditions and has been exacerbated by the culture shifts in the last several decades like Western lifestyle habits, pollution, poor diet and tobacco use. This study, intended to expand over subsequent years by large numbers, is an effort to legitimize some of the oft-ignored benefits of Traditional Chinese Medicine. (15)

I find it curious that suboptimal health status (SHS) has many of the same tenets as what we refer to as adrenal fatigue. Actually, people classified as having SHS have “significantly higher levels of plasma cortisol,” and confirm the correlation between stress and suboptimal health. This has led those studying SHS to realize that reducing the stress in work environments may help to prevent chronic diseases in the future. (16)

According to the Mayo Clinic, severe adrenal fatigue symptoms may actually be Addison’s disease. This disease occurs when your adrenal glands stop producing sufficient amounts of cortisol permanently, due to autoimmune disease or damage to the adrenal glands or pituitary glands. Unlike adrenal fatigue, Addison’s disease is marked by unexplained weight loss, rather than gain. The Mayo Clinic urges anyone with symptoms such as hyperpigmentation (darkening of skin), severe fatigue, unexplained weight loss, major gastrointestinal issues, lightheadedness/fainting, salt cravings and muscle or joint pain to see a physician immediately.


Adrenal Fatigue Symptoms

What happens when the adrenal glands stop producing hormones efficiently? Every bodily function is affected, and as adrenal hormone levels ebb and flow abnormally, even the normal “get-up-and-go” you get from them disappears. Adrenal fatigue symptoms include: (17)

  • Autoimmune conditions
  • Chronic fatigue (always feeling tired)
  • Brain fog
  • Hair loss
  • Hormone imbalance
  • Weakened stress response
  • Insulin resistance
  • Lightheadedness
  • Decreased sex drive/libido
  • Moodiness and irritability
  • Depression
  • Muscle or bone loss
  • Skin ailments
  • Sleep disturbances
  • Weight gain
  • Sweet and salty food cravings

As you can see, there are a number of symptoms that might be related to other underlying disorders. Fortunately, the ways to combat these issues are very similar and will benefit your overall health. If you’ve experienced any of these adrenal fatigue side effects, take heart, for there are now many natural ways to treat and support your adrenal system.


3 Steps to Overcome Adrenal Fatigue

Treatment for adrenal fatigue involves reducing stress on your body and your mind, eliminating toxins, avoiding negative thinking and replenishing your body with healthy foods, supplements and ways of thinking.

If you’re asking, “How can I help my adrenal glands?” the answer may be closer than you think — adrenal fatigue treatment looks a lot like the healthy, healing diets to help combat the underlying issues causing a number of conditions.

1. Follow the Adrenal Fatigue Diet

In every case of adrenal recovery, diet is a huge factor. There are a number of foods that offer adrenal support, helping to replenish your adrenal energy so your system can come back to full health. But first, you must start by removing any hard-to-digest foods and any toxins or chemicals in your environment.

The idea is to remove anything that taxes your adrenals. Foods to avoid include:

Caffeine: This can interfere with your sleep cycle and make it hard for your adrenals to recover. If you must drink coffee or a caffeinated beverage, then have a limited amount in the morning before noon.

Sugar and sweeteners: Includes avoiding high-fructose corn syrup and artificial sweeteners as well. Avoid sugary foods, cereals, candy, sweets, etc. Be aware that sugar is an additive in many breads, condiments and dressings. Try to avoid as much extra sugar as possible. Seek the benefits of raw honey or stevia as an alternative, and always moderate your use of sweeteners of any kind.

Carbohydrates: While carbohydrates aren’t all bad for you, the inflammation they can cause is particularly problematic when experiencing adrenal fatigue. Many people crave carb-heavy foods when they’re stressed, which offer a momentary satisfaction but end up taxing the adrenal glands more. If you’re overwhelmed and stressed out, try kicking the gluten and starchy carbs for a period of time to see if that may regulate your tiredness and energy levels.

Processed and microwaved foods: First of all, the microwave has its own dangers, but additionally, most microwaveable, ultra-processed foods have many preservatives and fillers that are hard to digest and wear out your body’s energy and digestion cycle. Try to buy food on the outer walls of your grocery store and prepare your own food whenever possible.

Processed meats: An overload of protein can stress your hormones more than you might think, and the added hormones and lacking nutrition in conventional, processed meats (particularly red meats like beef and steak) can throw your system out-of-whack in quick succession. When buying meats for adrenal support, stick to grass-fed beef and free-range chicken or turkey, and eat these protein-heavy meats only in moderation.

Hydrogenated oils: Vegetable oils like soybean, canola and corn oil are highly inflammatory and can lead to adrenal inflammation. Try to only use good fats such as coconut oil, olive oil, organic butter or ghee.

Next, you want to add nutrient-dense foods that are easy to digest and have healing qualities. Some of the top superfoods for adrenal health include:

These foods help overcome adrenal fatigue because they’re nutrient-dense, low in sugar and have healthy fat and fiber.

 

How to heal adrenal fatigue - Dr. Axe

 

2. Take Adrenal Fatigue Supplements and Herbs

Another big key to overcoming adrenal fatigue is taking the right supplements using supporting herbs. I always recommend eating the right foods to heal your body. However, it can still be a challenge to get enough of every nutrient you need every day. Therefore, it can be useful to wisely use dietary supplements for vitamins and minerals particularly vital for adrenal support.

In addition, there are certain herbs, spices and essential oils that can help to fight adrenal fatigue and support an energetic, vibrant life.

Adaptogenic herbs ashwagandha, rhodiola rosea, schisandra and holy basil: Research indicates that adaptogen herbs may help to lower cortisol levels and mediate stress responses within the body. (18, 19, 20) By using these herbs in food preparation, you can alleviate some of the strain on your adrenal glands.

Licorice root: This spice is available in extract form and helps to increase the DHEA in your body. (21) Licorice root is associated with some side effects and may sometimes be avoided by taking DGL licorice. (22) Pregnant women and those with heart, liver or kidney problems should avoid licorice root. Don’t take it for more than four weeks at a time. (23)

Fish oil (EPA/DHA): There are a large number of benefits of supplementing with fish oil (or, for people on vegan or other plant-based diets, algal oil). Several of these include counteracting a number of adrenal fatigue-related symptoms and complications, such as diabetes, mental dysfunction, arthritis, immune system function, skin issues, weight gain and anxiety/depression.

Magnesium: For some time, magnesium has been understood as one of the necessary nutrients for fighting adrenal insufficiency, a medical condition I’ll dive into below. (24) While the mechanisms of this aren’t fully understood, you may benefit from supplementing with magnesium if you are suffering from adrenal fatigue.

B-Complex vitamins: Research has found that vitamin B12 deficiency may be associated with stress on the adrenal cortex in some animals. (25) Vitamin B5 is another commonly deficient vitamin in people with adrenal stress. Especially if you’re reducing or eliminating meat from your diet in order to fight adrenal fatigue, it may serve you well to take a high-quality B-complex vitamin supplement.

Vitamin C: Known as a “stress-busting” nutrient, vitamin C has been found to minimize the effects of stress on people as well as reduce the time necessary to bounce back from stressful events. (26)

Vitamin D: In addition to maintaining homeostasis between magnesium and phosphorus in the body and supporting strong bones, Vitamin D has also more recently been seen to have impact on other conditions, including adrenal dysfunction and disease. (27)

Selenium: At least one animal study has found that selenium deficiency can negatively impact adrenal function. (28)

Lavender oil: Human and animal studies show that lavender essential oil has a calming effect that can reduce stress. (29) Research also suggests that it may lower high cortisol levels when inhaled. (30a, 30b)

Rosemary oil: Rosemary essential oil (along with lavender) can help to decrease cortisol concentrations and reduce oxidative stress on cells. (31)

I always recommend using whole-food-based supplements from reputable companies and using only 100 percent, therapeutic grade, USDA Certified Organic essential oils. Make sure you trust what you’re purchasing.

3. Reduce Adrenal Fatigue Stress

The last and most important key to restoring your adrenal function is to heed your mind and stress needs. Pay attention to your body!

  1. Rest when you feel tired as much as possible.
  2. Sleep 8–10 hours a night.
  3. Avoid staying up late and stay on a regular sleep cycle — ideally, in bed before 10 p.m.
  4. Laugh and do something fun every day.
  5. Minimize work and relational stress however possible.
  6. Eat on a regular food cycle, and reduce your caffeine and sugar addiction.
  7. Exercise (even moderate exercise and walking can help). Yoga, in particular, can help to improve quality of life and reduce stress responses. (32)
  8. Avoid negative people and self-talk.
  9. Take time for yourself (do something relaxing).
  10. Seek counsel or support for any traumatic experiences.

Let’s talk about “self-talk” for a minute. Our bodies are made to heal. However, the words we say have a great impact on our body and our ability to heal. Regardless of what diet and supplements you take, your environment is one of the most important components.

So, be kind to yourself. Try to avoid saying negative things about yourself and others. It’s important to choose to be around positive people and stay positive about yourself as well.

Many people roll their eyes at such advice, but it’s scientifically proven that it’s possible to reduce pathological worry by practicing “thought replacement,” a positive self-talk practice that involves verbally reciting positive outcomes to stressful situations. (33)


Signs of When to Go to the Endocrinologist for Adrenal Fatigue

Many people go for some time without consulting their general physician or endocrinologist about some of the symptoms of adrenal fatigue. However, experiencing high cortisol symptoms over a long period of time can really take a toll. In addition, some symptoms can be indicative of more serious conditions.

It’s probably time to visit the endocrinologist if:

  • You experience one or a combination of adrenal fatigue symptoms for an extended period of time
  • Your symptoms have begun interfering with normal life relationships and/or activities, such as work, family time or school
  • Dietary and lifestyle judgments have not significantly improved your symptoms
  • Your sleeping patterns have shifted into insomnia and/or you are no longer able to get restful sleep, no matter how long you’re in bed
  • You experience hyperpigmentation, or patches of darker skin on your body
  • You are a woman who has ceased menstruating
  • You experience dizziness and/or overall weakness for multiple consecutive days with no explainable cause (such as flu, concussion or excessive exercise)
  • You are unsure of how or unable to study adrenal fatigue supplements to safely take them, or unsure of how to structure an adrenal fatigue diet

Because of the controversial nature of this condition, you may need to seek out a naturopath who will help you treat adrenal fatigue with a combination of dietary advice and supplement recommendations, as well as any hormonal or other medications necessary.

An oral dose of 20 milligrams of hydrocortisone is recommended by some for routine cortisol management, while an occasional dose of 50 milligrams may be prescribed but should not be taken regularly or in higher doses. (34) Your physician or endocrinologist should help you understand the potential side effects of this and any other medication they recommend.

Adrenal Fatigue Tests

Tests for adrenal fatigue are, unfortunately, another source of confusion for many. You should know ahead of time that these tests must be done by someone who understands the nature of adrenal fatigue and that tests for adrenal fatigue are rarely definitive.

The most common of these tests include testing bodily fluid for cortisol. Blood tests are almost never helpful in this regard, but a 24-hour salivary panel may help your doctor recognize abnormal cortisol patterns, including a lack or overload of stress response. Many doctors also test thyroid function in conjunction with cortisol levels because of the way these hormonal systems are interconnected.

Other tests that may be used to help diagnose or confirm adrenal fatigue include: (35)

  • ACTH Challenge
  • TSH test (thyroid stimulating hormone)
  • Free T3 (FT3)
  • Total Thyroxine (TT4)
  • Cortisol/DHEA ratio
  • 17-HP/Cortisol ratio
  • Neurotransmitter testing

There are also two safe home tests you can try. The first is known as the Iris Contraction Test and was developed in 1924 by a Dr. Arroyo. His theory was that the iris would not be able to properly contract when exposed to light in people with weakened adrenal function, so the test involves sitting in a dark room and shining a flashlight briefly across the eyes repeatedly. If you have adrenal fatigue, it’s possible that the eye contraction will last no more than two minutes and the eyes will dilate even when still exposed to direct light.

You may also try the Postural Low Blood Pressure test. In healthy individuals, blood pressure rises when rising from a laying position. Using a blood pressure monitor, you can test your pressure when laying down and then after standing. If you see no rise or a drop in blood pressure, it’s possible your adrenals have been weakened.


How Adrenal Fatigue and Osteoporosis Are Related to One Another

A relatively new area of understanding, there are some who make the connection between adrenal fatigue and osteoporosis. It’s well-known that osteoporosis is often a result of imbalanced hormones. However, the sex hormones that are often named as the transgressors aren’t the only problem. Abnormally high or low cortisol levels are also associated with bone loss and osteoporosis risk. (36, 37, 38)

One possible reason for this is the mineralocorticoids regulated by cortisol and aldosterone, during your body’s response to stress. When these hormones don’t manage the mineral balance via these mineralocorticoid hormones, bone loss can occur.

Nutritional deficiencies can exacerbate or speed the development of osteoporosis as well, so improving your diet to remove pro-inflammatory foods can improve your risk factors for both of these disorders.

While there is not proof as of yet that adrenal fatigue directly causes osteoporosis, the evidence of the connection between abnormal cortisol levels and osteoporosis should give you pause about loading up on non-nutritious foods and ignoring symptoms of hypoadrenia.


Adrenal Fatigue vs. Adrenal Insufficiency vs. Addison’s Disease vs. Cushing’s Syndrome/Disease

When discussing problems with adrenal function, it’s important to understand that adrenal fatigue is not the same thing as adrenal insufficiency, Addison’s disease or Cushing’s syndrome/Cushing’s disease.

Adrenal Insufficiency and Addison’s Disease

Symptoms found in adrenal insufficiency that are not found in adrenal fatigue include major digestive issues, weight loss, low blood sugar, headache and sweating (as well most of the symptoms common in hypoadrenia, save weight gain).

Primary adrenal insufficiency is what is known as Addison’s disease and occurs when the adrenal glands are damaged by some type of trauma and can’t produce enough cortisol or aldosterone. The much more common type of adrenal insufficiency is known as secondary adrenal insufficiency and occurs when the pituitary gland stops producing adenocorticotropin (ACTH). ACTH is what stimulates the adrenal glands to produce cortisol, so it stops this process from moving along. (39)

The skin darkening that concerns endocrinologists most often occurs in Addison’s disease, but not secondary adrenal insufficiency. The latter of these conditions is often not diagnosed quickly because people ignore symptoms until they are drastically obvious. People with adrenal insufficiency do experience severe fatigue, often not reflected by salivary cortisol levels. (40)

Those with adrenal insufficiency may suffer an adrenal crisis if symptoms of adrenal disease are ignored. An adrenal crisis (known sometimes as an Addisonian crisis in those with Addison’s disease) is marked by symptoms like severe, sudden pain in the legs, back or abdomen, severe vomiting/diarrhea, dehydration, low blood pressure and loss of consciousness.

What differentiates adrenal insufficiency from adrenal fatigue? More often than not, adrenal fatigue is modeled by an overabundance of cortisol, often at the “wrong” times, while adrenal insufficiency is a consistent inability to produce cortisol. They are related, though — many natural medicine practitioners, such as myself, see adrenal fatigue as a precursor to adrenal insufficiency. In fact, a description of adrenal insufficiency from the Cleveland Clinic states that “its early clinical presentation is most commonly vague and undefined, requiring a high index of suspicion.” (41)

The largest difference between them is that people with adrenal fatigue usually have cortisol levels that fall in “normal” levels but not “optimal,” while adrenal insufficiency patients have cortisol levels consistently outside the normal range. In addition, most conventional doctors would say that stress is not a causative factor in adrenal insufficiency (which is “always caused” by damage from other, unknown sources), which seems unlikely.

Immune responses are limited in people suffering from adrenal insufficiency, who cannot physiologically respond to pathogens like healthy individuals. (42)

Cushing’s Syndrome/Disease

An extremely rare condition, Cushing’s disease is an overproduction of cortisol, outside the normal levels, that most often affects women between 25–40. Sometimes, Cushing’s is a result of tumors, while other times it can be idiopathic (no known cause). In these cases, it’s possible that adrenal fatigue and/or diet and lifestyle habits may have contributed to the condition.

Cushing’s can be reversed and is defined as a “curable” condition by the National Institute of Health, although those with previous tumors need regular checkups to assess any future tumor growth, and those who have had Cushing’s in the past are at a higher risk for diabetes, high blood pressure or high cholesterol. (43)

Unique symptoms of Cushing’s syndrome (called Cushing’s disease when caused by a pituitary tumor) include abdominal/facial weight gain, male impotence, failure to menstruate, increased risk of miscarriage, high blood sugar and high blood pressure. (44)


How Long Does It Take to Recover from Adrenal Fatigue?

It’s not an easy question to answer, because adrenal fatigue recovery time has never been studied. Recovery for adrenal fatigue can take a little while, though. After all, it took months, maybe years, to wear out your adrenals; so it takes a little time to build up their strength again. For full adrenal recovery, you can expect it to take:

  • 6–9 months for minor adrenal fatigue
  • 12–18 months for moderate fatigue
  • Up to 24 months for severe adrenal fatigue

The best approach is to make solid changes to your lifestyle for lasting results. Some people notice a difference in their overall well-being after just a few weeks of better foods that aid in detoxification of the body and adrenal fatigue supplements. If you aim for a balanced lifestyle with a healthy level of sleep, exercise, fun and a positive environment, then you are most likely to keep your adrenal system going strong!


Precautions

Many doctors are concerned with adrenal fatigue diagnoses and their legitimacy, in part, because they don’t want people to improperly “treat” themselves for a condition and end up worse than they were to begin. That’s okay, because I don’t want you to be in a worse state, either!

First, remember that any new dietary regimen or addition of supplements in your lifestyle should be implemented under the supervision of a physician/naturopath you trust. In general, introducing more plant-based foods into your lifestyle and eliminating stimulants, sugary foods and processed items with a ton of sodium or chemicals added to them is going to help you feel and live better, regardless of conditions you may or may not have.

The larger concern comes when referring to herbs, spices, supplements and essential oils used to combat adrenal fatigue. Keep these precautions in mind and don’t blindly use these without medical supervision or proper education on how, how much, how often and how long to use these supplements.

Medicinal Mushrooms: Because of the way mushrooms such as cordyceps and chaga interact with the body and various medications, it is recommended that pregnant or nursing mothers never use them. In addition, anyone with autoimmune conditions, diabetes or a bleeding disorder should use medicinal chaga or cordyceps. These is one case report of chaga supplementation causing kidney damage in a woman with liver disease who took chaga every day for six months. This mushroom also contains oxalates and may inhibit some nutrient absorption in large doses. (45)

Adaptogen Herbs: Many people recommend only using one adaptogen herb at a time (and not every day), then switching to a different one. Due to a lack of evidence about their safety during pregnancy, adaptogen herbs should never be used by pregnant or nursing mothers.

Rhodiola rosea has been known to (uncommonly) cause allergy, insomnia, irritability, increased blood pressure and chest pain. It may interfere with psychotropic drugs, birth control pills, diabetic and thyroid medication, as well as add to the stimulant effects of caffeine and affect platelet aggregation.

While understood as fairly safe when taken in the short-term, ashwagandha has not been studied for long-term usage effects. Too-large doses may lead to digestive symptoms including nausea, diarrhea and vomiting. People with diabetes, irregular blood pressure, stomach ulcers, autoimmune diseases, thyroid disorders or upcoming/recent surgery should not use ashwagandha.

Holy basil, an Ayurvedic medicine gold mine, is known to be safe for up to six weeks, while long-term effects are unknown. In addition, you shouldn’t take holy basil before or after surgery because it could increase your risk of bleeding.

Essential Oils: Understanding the ins and outs of essential oils can be a large task, but the two generally recommended for adrenal support, lavender and rosemary, are somewhat straightforward. Neither have been tested on pregnant women and therefore should not be used while carrying a baby or nursing.

Lavender oil shouldn’t be used alongside any other sedatives. Lavender oil is also generally recognized as safe when it comes to oral use (when looking at 3 drops at a time diluted in water).

Rosemary oil should never be used internally, as it can cause vomiting and spasms. You may inhale it, or use it topically at a 50:50 dilution of a carrier oil.


Final Thoughts

  • Adrenal fatigue is a controversial condition, coined by Dr. James L. Wilson in the late 1990s.
  • This condition is considered to be an “in-between” state of health, before reaching a state of diagnosable disease, that is characterized by several general symptoms affecting various body systems, similar to China’s classification of suboptimal health symptoms.
  • Adrenal fatigue is said to be caused by high levels of chronic stress that lead to a taxing of the adrenal glands, forcing them to overproduce or underproduce cortisol, the stress hormone, at the wrong times.
  • Many believe that adrenal fatigue can lead to more serious adrenal diseases like adrenal insufficiency or Cushing’s syndrome.
  • Common symptoms of adrenal fatigue include severe tiredness, brain fog, decreased sex drive, hair loss, insulin resistance and others.
  • To naturally fight adrenal fatigue, remove inflammatory foods from your diet such as sugar and excess carbohydrates, and eat plenty of colorful, plant-based foods, free-range lean meats such as chicken or turkey, and lots of healthy fats.
  • There are a variety of herbs, spices, supplements and essential oils that may be used to combat adrenal fatigue. These should be used under medical supervision.
  • If you experience symptoms for an extended period of time or have certain issues like patches of darkened skin, consult an endocrinologist immediately for help.

Read Next: Licorice Root Benefits Adrenal Fatigue & Leaky Gut


From the sound of it, you might think leaky gut only affects the digestive system, but in reality it can affect more. Because Leaky Gut is so common, and such an enigma, I’m offering a free webinar on all things leaky gut. Click here to learn more about the webinar.

Josh Axe

Get FREE Access!

Dr. Josh Axe is on a mission to provide you and your family with the highest quality nutrition tips and healthy recipes in the world...Sign up to get VIP access to his eBooks and valuable weekly health tips for FREE!

Free eBook to boost
metabolism & healing

30 Gluten-Free Recipes
& detox juicing guide

Shopping Guide &
premium newsletter

More Conditions