Adrenal Fatigue

As a health nut, I am the queen of fast and accurate medical/ health info.  I find myself reading blog posts or social media “science” daily, and  I geek out on supplements and integrative therapies for health prevention or promotion. For a long time I found so much of it interesting and didn’t research further. Over time, I realized so much of the information in the alternative med world is questionable, can be debated or can be just down right inaccurate. Its difficult to know what to believe. Im not a naturopathic doctor, but I do have degrees in health promotion and nursing. I know how to screen and filter research and pull out the pertinent info. And break it down for more simple explanations. I have a strong passion for blending western + eastern medicine, finding the balance between traditional homeopathic remedies, lifestyle habits and newfound research and pharmaceuticals.

So – heres a lil tid bit on adrenal fatigue because as an aspiring integrative and holistic NP, that term gets me so fired up. I hope this provides some insight, and a better understanding of what is going on inside our bodies!

First things first: The Endocrine System. This is a fancy name for hormones. Hormones are not just estrogen and testosterone as often assumed , but there are over 50 hormones in our bodies, produced from 3 places that influence one another . Our hypothalamus, our pituitary, and our adrenals. These three work in synchrony to maintain an equilibrium and biofeedback system of hormonal balance for our bodies. All are critical, but I am going to focus on the adrenals specifically adrenal fatigue, as they are most commonly discussed, misunderstood and cortisol is everyone’s fave!

What are adrenals: your adrenal glands are hormone producing glands that sit on top of your kidneys. They work in conjunction with your hypothalamus and pituitary glands in the brain to secrete and produce hormones to our bloodstream.

Made up of : adrenal cortex and medulla


Cortex– outer region with 3 zones (zona glomerulosa, zona fasciculata and zona reticularis) that produce specific hormones.

a. Zona glomerulosa– mineralocorticoids ( such as aldosterone) – help regulate blood pressure, sodium and potassium (electrolyte balance)

b. Zona Fasciculata– Glucocorticoids or cortisol! Everyones favorite to talk about – responsible for how body metabolizes fat protein and carbs into energy. Cortisol also plays a role in blood pressure regulation, sleep wake cycles and immunity.

c. Zona Reticularis– Sex hormones- DHEA- which are precursor hormones later converted into estrogen, and testosterone

Medulla– in the cortex, secretes adrenaline (epinephrine) and noradrenaline (norepinephrine) involved with fight or flight, anxiety, excitement, etc which regulate blood flow, sugar, and blood pressure responses to stress.

So what is adrenal fatigue, and why is this important?

Adrenal fatigue: a phrase often used by alternative or integrative medicine providers to explain a myriad of symptoms. Common diagnosis linked to adrenal fatigue

  • Body aches
  • Extreme fatigue regardless of hours of sleep
  • Increased cravings for stimulants or caffeine
  • Hair loss
  • retention and memory difficulty
  • Orthostatic hypotension
  • difficulty fighting off infections and increase number of cough/cold./flu
  • Pain in back or neck
  • heart Palpitations
  • Reduced tolerance for stress or easily overwhelmed
  • Depression/anxiety

“Theory”: exposure to chronic stress over a long period of time causing the adrenals to over produce cortisol to compensate, eventually leading to a decrease in  production and overall failure of the adrenals to keep up due to “overuse”

Simplified: over stressed – over secrete cortisol – then depletes and over time they fatigue.

My Take: Chronic stress? absolutely. Fatigue? all the way. Adrenal fatigue: I am not sold. Its an ongoing debate especially in the alt. Med world, but hear me out. I absolutely believe chronic stress and elevated levels of cortisol over an extended period of time can wreak havoc on our bodies causing a myriad of awful symptoms. I believe we can experience the symptoms above from chronic stress, but I struggle to accept that at some point our adrenals stop secreting enough cortisol.

Looking at a systematic review done in 2016, they took 58 studies and concluded that adrenal fatigue is not a medical condition. It is unrecognized by the American Board of Medical Specialties and Association of American Medical Colleges.

Does that mean I dont believe in supporting or managing stress ? Absolutely not. It also doesn’t mean that I dismiss anyone that exhibits these symptoms. I just believe that there are supplements, foods and behaviors that can support our hormones and adrenals without labeling it as “Adrenal fatigue”.

That being said – do not confuse “adrenal fatigue” with adrenal insufficiencies which are not only real but critical.

1. Addison’s disease occurs when your adrenal glands are damaged and cannot make enough cortisol or aldosterone-. This is acute, severe and critical.

  1. Secondary adrenal insufficiency- The pituitary doesn’t make enough ACTH, therefore affecting the adrenals ability to secrete cortisol since cortisol is ACTH dependent.
  2. Tertiary adrenal insufficiency – The hypothalamus doesn’t make enough corticotrophin releasing hormone, therefore the pituitary cant make enough ACTH, and then the adrenals as the last piece of that puzzle cant secrete cortisol.
    *all of these are extremely dangerous and need immediate intervention with steriods- can be caused by a myriad of things and I can explain more on this if anyone is interested.

I think getting cortisol levels tested can be a great indicator of how your body is responding to stress, measuring your levels and where you are with regulation and response. These results will aid in how to best support your adrenals,  and preventive actions you can take if you know you are going to endure something stressful either physically or mentally.


DUTCH – urine hormone testing  (measures cortisol levels over 24 hours), shows active and inactive cortisol levels and metabolites, measures free and total cortisol amongst other hormones

Saliva – levels day and night, and bioavailable levels

Morning cortisol blood-  total cortisol in blood at time of test (much less accurate, also most common)

Pupil contraction: looks at pupils in dark and light


  1. Manage blood sugar- balanced diet, cutting out alcohol, avoid processed foods
  2. Stress reduction – pranayama, yoga, walks, cleaning your living space, essential oils, things that bring you joy
  3. Light- keep your room dark at night, wear yellow glasses to block blue light from screens, or turn off 3 hours before bed. Our pineal glands are affected by screens!
  4. Sleep – I know, these are all pretty duh but they really make a difference!


Vitamin B5

Herbs- ashwaganda, ginseng, maca, turkey tail mushroom

Buffered Vitamin C (my fave!)


Adaptogens- help body regulate stress! (I have a lot more I can write on these too!).




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