Evidence Based

This Dr. Axe content is medically reviewed or fact checked to ensure factually accurate information.

With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Note that the numbers in parentheses (1, 2, etc.) are clickable links to these studies.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Note that the numbers in parentheses (1, 2, etc.) are clickable links to medically peer-reviewed studies.

Our team includes licensed nutritionists and dietitians, certified health education specialists, as well as certified strength and conditioning specialists, personal trainers and corrective exercise specialists. Our team aims to be not only thorough with its research, but also objective and unbiased.

The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

What Is Adrenal Fatigue? 3 Steps to Overcome Naturally

By

Reviewed by Marcelle Pick, MSN, OB-GYN NP, Pediatric NP

Adrenal fatigue - Dr. Axe

Did you know that chronic stress can affect your body’s ability to recuperate from physical, mental or emotional stress? This is likely why most people have dealt with adrenal fatigue at some point in their lives.

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.

Because the adrenals influence many parts of the body, symptoms of adrenal fatigue can mimic a number of disorders and isn’t always easily recognizable.

Adrenal fatigue symptoms, like brain fog, moodiness and trouble sleeping, can be indicative of many disorders and are often overlooked by doctors. But more and more people are starting to realize that a combination of these health issues often indicate the onset of adrenal fatigue.

If you have adrenal fatigue, it can have significant effects on your overall health. Luckily, you can improve this common issue naturally by focusing on your nutrient-intake and lifestyle choices.

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 long-term stress could lead to an inconsistent level of cortisol (the stress hormone) in the bloodstream.

In addition to this overload or improper stress hormone levels, people with adrenal fatigue often don’t have enough DHEA, the “parent hormone” responsible for the creation of many necessary hormones in the body.

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
  • you 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.
  • your energy finally peaks again at 11 p.m.

Is adrenal fatigue real?

The major issue with recognizing or diagnosing adrenal fatigue is the inability to distinguish its symptoms and patterns from other disorders. The 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.

A diagnosis for this condition is difficult because stress hormone levels typically fall in what conventional medicine would call “inside the normal range,” although the symptoms are clear to those suffering from the condition.

People who believe that adrenal fatigue isn’t a real health concern often state that consistent levels of chronic stress have no effect on the adrenals and the only true endocrine disorders are those caused by other diseases and direct damage to the adrenal glands.

However, many practitioners of natural medicine know, from experience in a 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?

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.

The adrenal glands work closely with the hypothalamus and the pituitary gland in a system known as the hypothalamus-pituitary-adrenal axis (HPA axis).

Adrenal glands play a huge role in stress response. Here’s how it works:

  • 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.

Comparisons

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.

Here’s a quick breakdown of these conditions and how they are different than adrenal fatigue:

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.
  • 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.
  • Secondary adrenal insufficiency (which is more common) occurs when the pituitary gland stops producing adenocorticotropin (ACTH). ACTH is what stimulates the adrenal glands to produce cortisol.
  • What differentiates this condition from adrenal fatigue? More often than not, adrenal fatigue is modeled by an overabundance of stress hormone levels, often at the “wrong” times, while adrenal insufficiency is a consistent inability to produce cortisol.
  • 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.

Cushing’s Syndrome/Disease

  • Cushing’s disease is an extremely rare disease that involves the overproduction of cortisol, outside the normal levels, that most often affects women between 25–40.
  • This condition is sometimes the result of tumors and in other cases, there is no known cause.
  • Cushing’s can be reversed and is defined as a “curable” condition by the National Institute of Health.
  • 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.

Causes

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 (especially for over a year), ongoing 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
  • Food sensitivities
  • Adverse events in childhood
  • Surgery
  • Reliance on stimulants like caffeine or energy drinks
  • Rheumatoid arthritis
  • Diabetes/impaired glucose levels

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.

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.

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

And there’s research suggesting that hypothalamic dysfunction is common in multiple sclerosis, an autoimmune disease. Researchers are evaluating why dysfunction of the hypothalamic-pituitary-adrenal axis is common in multiple sclerosis, but it’s believed to be linked to abnormal cortisol secretion.

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.

Studies indicate that adrenal fatigue symptoms include:

  • 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/sleep apnea
  • Weight gain
  • Sweet and salty food cravings
  • Loss of appetite

As you can see, there are a number of symptoms that might be related to other underlying disorders, including some very common women’s health issues.

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.

Diagnosis

Many people go for some time without consulting their general physician or endocrinologist about some of the symptoms of adrenal fatigue. This is one major reason why diagnosis of this condition is uncommon.

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

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:

  • 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, which include:

  • The Iris Contraction Test: The theory behind this test is that the iris will not be able to properly contract when exposed to light in people with weakened adrenal function. 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.
  • 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 your levels, it’s possible your adrenals have been weakened.

Conventional Treatment

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.

Studies indicate that 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.

Your physician or endocrinologist should help you understand the potential side effects of this and any other medication they recommend.

Natural Treatments

Treatment for adrenal fatigue involves:

  • reducing stress on your body and your mind
  • eliminating toxins
  • avoiding negative thinking
  • 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 behind the adrenal fatigue diet is to remove anything that taxes your adrenals.

Foods to avoid include:

  • Caffeine: Caffeine 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: Try to avoid as much extra sugar as possible. This includes avoiding high-fructose corn syrup and artificial sweeteners as well. Avoid sugary foods, cereals, candy and sweets. Be aware that sugar is an additive in many breads, condiments and dressings. Seek 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.

Foods to add to your diet include:

  • Coconut
  • Olives
  • Avocado and other healthy fats
  • Cruciferous vegetables (cauliflower, broccoli, Brussels sprouts, etc.)
  • Fatty fish (e.g., wild-caught salmon)
  • Free-range chicken and turkey
  • Bone broth
  • Nuts, such as walnuts and almonds
  • Seeds, such as pumpkin, chia and flax
  • Kelp and seaweed
  • Celtic or Himalayan sea salt
  • Fermented foods rich in probiotics
  • Chaga and cordyceps medicinal mushrooms

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. Supplements and Herbs

Another major change to overcoming adrenal fatigue is taking the right supplements using supporting herbs. Because it can still be a challenge to get enough of every nutrient you need every day, supplements can be used to ensure that you are getting the vitamins and minerals that are 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 shows that adaptogen herbs may help to lower cortisol levels and mediate stress responses within the body. 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 has been shown to help increase the DHEA in your body. Licorice root is associated with some side effects and may sometimes be avoided by taking DGL licorice. Research suggests that 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. Make sure to monitor blood pressure, as levels can increase in some patients.
  • 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, gaining weight and anxiety/depression.
  • Magnesium: Magnesium is one of the necessary nutrients for fighting adrenal insufficiency. 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 finds that vitamin B12 deficiency may be associated with stress on the adrenal cortex in some animals. 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 appears to minimize the effects of stress on people as well as reduce the time necessary to bounce back from stressful events.
  • Vitamin D: In addition to maintaining homeostasis between magnesium and phosphorus in the body and supporting strong bones, vitamin D may impact other conditions, including adrenal dysfunction and disease.
  • Selenium: At least one animal study finds that selenium deficiency can negatively impact adrenal function.
  • Lavender oil: Human and animal studies show that lavender essential oil has a calming effect that can reduce stress. Research also suggests that it may lower high cortisol levels when inhaled.
  • Rosemary oil: Rosemary essential oil (along with lavender) may decrease cortisol concentrations and reduce oxidative stress on cells.

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

3. Reduce 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 and try the following natural stress relievers:

  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. If you feel tired after exercise, it’s sometimes beneficial to only walk until adrenals are sufficiently healed.
  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.

4. Recovery

How long does it take to recover? 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!

Risks and Side Effects

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. Don’t blindly use any new supplements, herb or essential oil without medical supervision or proper education on how, how much, how often and how long to use these supplements.

There are several herbs that should not be used when pregnant or breastfeeding. This includes medicinal mushrooms, adaptogenic herbs and some essential oils.

Final Thoughts

  • Adrenal fatigue is a controversial condition considered to be an “in-between” state of health, before reaching a state of diagnosable disease.
  • It’s 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.
  • 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.
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 Health

Ad