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Wired and Tired: How to Cope With Adrenal Fatigue and Cortisol Imbalance

Evidence-based Reviewed Article

A man reading a study about cortisol and stress effects.Many people find themselves feeling both wired and tired, weary but incapable of relaxing. They may find falling asleep at night difficult, even after a long, tiresome day. And often, when they do finally fall asleep, they do not wake up feeling rested, despite sleeping the recommended eight hours. Common relaxation techniques, such as meditation or deep breathing, may have no effect. No matter what they try, their body refuses to shut down and let go. This scenario is often a result of chronic stress, adrenal fatigue and cortisol imbalances.

You may want to be assessed for adrenal fatigue if you are constantly wired and tired throughout the day and are often unable to fall asleep at night. Though there are many causes of sleeping issues, cortisol imbalance is a common one.

A scenario like this could also play havoc with your personal life. Mundane tasks can become very challenging, and enjoyment of previous passions and social events may slowly dwindle. You may end up drinking too many caffeine and energy drinks but find they do not work. Perhaps the most frustrating aspect is the sense of helplessness. Understanding the role of stress, adrenal fatigue and cortisol in this common condition is key to remedying it.

About Cortisol, Stress, and Fatigue

Feeling wired and tired is often related to stress. The body’s way of coping with stress is to produce more cortisol via the adrenal glands. However, the body is designed for cortisol to drop after a stressor has passed. When stress is chronic, cortisol levels can become chronically high. This is the beginning of adrenal fatigue. Eventually, this could end up weakening the adrenal glands and causing cortisol levels to fall.

In the early stages of adrenal fatigue, the body compensates well and shows few noticeable symptoms. However, in the more advanced stages of adrenal fatigue, the body’s coping mechanisms become imbalanced. Many related bodily functions, such as energy and blood sugar levels, can become imbalanced. One of the most noticeable impacts is the slowing down of cortisol production, which can lead to fatigue and an inability to handle stress.

To make up for this, the body activates the sympathetic system, part of the neuroaffect response. The neuroaffect response is mediated by the sympathetic nervous system, the central nervous system, and the digestive system as a survival mechanism to deal with stress, releasing norepinephrine throughout the body. This release gives the body a jolt of energy to respond to stress factors. However, because it interacts with the central nervous system, it can also increase your heart rate and anxiety levels. Even when your body is exhausted and out of energy, the continuous flow of norepinephrine will keep you alert, resulting in the wired and tired feeling.

Healthy vs. Unhealthy Cortisol Levels

Sleep can be interrupted by chronic stress. Learn more about cortisolIn a healthy adrenal system, cortisol levels reach their maximum in the morning. This increase helps to stimulate and wake you up. As the day progresses, cortisol levels slowly drop. As cortisol levels go down, your body is able to relax and unwind so that you can go to sleep. Essentially, cortisol helps people maintain awareness when they need to be awake and promotes fatigue when they need to be asleep. Healthy cortisol levels make it easier to maintain regular sleep-wake cycles.

Of course, for those experiencing adrenal fatigue, their adrenal glands do not produce appropriate levels of cortisol. As a consequence, cortisol levels tend to fluctuate throughout the day, being too low in the morning or too high at night, for example. This can lead to symptoms like difficulty waking, fatigue, sugar or snack cravings, blood sugar spikes and crashes, and insomnia.

Stages and Symptoms of Low Cortisol

In the early stages of adrenal fatigue and cortisol imbalance, the problem is very minor and easy to reverse. It might be noticeable, but not to a great degree. However, healing takes longer as adrenal fatigue progresses.

Cortisol levels become lower in the morning and higher at night, resulting in sleep disruption and increased levels of stress. This only serves to aggravate the issue, causing you to feel wired and tired more often. The more you neglect the problem, the more tired you become. This is why it is essential to manage stress and normalize cortisol levels.

Signs of low cortisol include:

  • muscle aches and weakness
  • hypoglycemia
  • shakiness
  • strong cravings for sugar or salt
  • extreme fatigue
  • swollen ankles
  • low blood pressure
  • brain fog
  • moodiness
  • inability to handle stress
  • infections that don’t seem to go away
  • longer recovery periods after exercising
  • difficulty getting out of bed in the morning

If you believe these symptoms may apply to you, it is important to look into adrenal fatigue as a potential cause. The wired and tired feeling can be a symptom of adrenal fatigue and the hormones the body uses to deal with stress. Once a cause has been identified, it can be addressed, and harmony can be restored to the body once again.

How to Deal with Adrenal Fatigue and Cortisol Imbalance

Conventional medicine does not yet acknowledge adrenal fatigue as a health condition. If you have some of the symptoms associated with the condition, you may need to find a medical professional versed in adrenal fatigue.

There are also several steps you can take to reduce stress, improve your cortisol regulation, and support your overall health. These can also help reduce the wired and tired feeling.

Healthy, Whole Food Diet

Food contains vitamins, minerals, and other essential nutrients that help your body with the healing process. Foods to help address adrenal fatigue and cortisol imbalances include:

  • Organic vegetables and fruit, especially leafy greens
  • Lean protein sources like legumes, chicken, turkey, and lean beef
  • Fatty fish due to their high omega-3 content (sardines, mackerel, tuna, and salmon)
  • Wholegrains like barley and rye
  • Water and herbal tea

Several diets include these foods, including the adrenal fatigue diet which is designed to support adrenal function.

Avoid processed foods. They heighten your risk of obesity, chronic heart issues, and diabetes. You should also drastically limit your sugar intake. Laden with calories, sugar can increase your obesity risk and many of the associated health issues. Most sugar substitutes have the same effect on the body as processed foods and sugar. If you have a sweet tooth, consider stevia. This natural herb has a sweet taste.

When you eat is also an important factor. Those with lower cortisol levels might have higher insulin secretion, leading to lowered blood sugar and reactive hypoglycemia symptoms. To mitigate that, eat a small, healthy snack every 2-3 hours or when you feel hungry.

Healthy Sleeping Habits for Adrenal Fatigue and Cortisol Issues

If you have difficulty sleeping, a few changes in your bedtime routine or to your bedroom itself may help with the situation.

  • Always sleep in a dark room.
  • Go to bed at the same time each night.
  • Keep technology out of your bedroom.
  • Stay away from the television, your cell phone, or other blue light sources for about an hour before bedtime.
  • Take a relaxing bath before going to bed.
  • Try drinking a glass of warm milk or a handful of almonds for a bedtime snack.
  • Try to drink water during the day but less before bed to reduce night waking.

Manage Stress

Learn about cortisol and stress effects on the body.One of the best ways to address adrenal fatigue and cortisol is to identify and then do something about your stressors. Stressors can include work, relationships, financial issues, anxiety, environmental toxins, and even health conditions. Reducing or removing stress is ideal.

Many of these stressors are not easy to avoid, however. In this case, it may help to learn more strategies to manage stress, including meditation, yoga, exercise, journaling, maintaining a positive attitude, gratitude, and picking up a hobby. Counseling may also help.

Herbs and Supplements

Many herbs and supplements may help you better deal with stress. Herbs that provide adrenal support include:

  • Rhodiola: Helps with stress, cortisol management, brain function, and fatigue. Recommended dosage is 100 - 400 mg a day.
  • Licorice root: Helps sustain adrenal hormone activity and provides digestive support. Recommended dosage is 100 - 990 mg daily.
  • Holy Basil: Has a balancing effect on cortisol levels and addresses inflammation. Recommended dosage is up to 500 mg per day for up to a maximum of 90 days.
  • Ashwagandha: Mitigates cortisol levels and anxiety. Recommended dosage is 250 - 500 mg per day.
  • Maca: Boosts energy levels and promotes stamina. Recommended dosage is 1.5 to 3.5 mg daily for up to sixteen weeks.
  • Gingko biloba: Strong antioxidant properties that fight off free radicals. Promotes mental health. Recommended dosage: 60 - 240 mg daily for up to six months.

Supplements to support healthy cortisol levels:

  • Vitamin C: Plays a role in cortisol production and supports your immune defense system. Recommended dosage: no more than 2,000 mg daily.
  • Vitamin B5 (Pantothenic acid): Plays a role in stress hormone production and in the manufacturing of red blood cells. Recommended dosage: 5 mg daily.
  • Magnesium: Helps with cortisol regulation. Recommended dosage: 310 - 420 mg daily.

Please remember that you should never start using these herbs or supplements without the guidance of a qualified healthcare practitioner. They may interact with certain medications and may not be suitable for you depending on your stage of adrenal fatigue. Your healthcare provider is also best able to suggest the proper dosage.


Exercise has been correlated with reducing cortisol levels and reactivity to stress. However, gentle exercise is best when you have adrenal fatigue and cortisol imbalances. Types of exercise to consider include yoga, Pilates, yoga, tai chi, and walking. Depending on your state of adrenal fatigue, a slow jog and lifting light weights may also help. Do consult your healthcare practitioner before starting a new exercise regime. Exercise during certain stages of adrenal fatigue may do more harm than good.

Breathing Exercises

Breathing exercises allow your body to relax. Because you need to keep your mind focused while doing them, they may also help with anxiety. Many people find breathing exercises coupled with meditation a good way to relax both body and mind.

Take Time to Relax

Make time for yourself. Even if it is watching an old movie rerun or going for a walk in nature. Do what makes you happy. You also need to make time for the people in your life. Visit friends and family, consider practicing a new hobby, or volunteer at a local charity.

The Takeaway

All too many people experience the feeling of being wired and tired. If this is you, then you need to learn about the connection between adrenal fatigue and cortisol. Here's what to do if this feeling is impacting your daily life:

  1. It's important to get help and support as early as possible to avoid the worsening of your symptoms.
  2. Reduce your stress levels, eat a healthy diet, and get enough sleep.
  3. Talk to a medical professional who's aware of adrenal fatigue and the effects it can have on your body and on your cortisol levels.

For more information on cortisol, adrenal fatigue, or general fatigue, the team at Dr. Lam Coaching can help. We offer a free** no-obligation phone consultation at +1 (626) 571-1234. You can also leave a question through Our Ask The Doctor system by clicking here.

© Copyright 2016-2023 Michael Lam, M.D. All Rights Reserved.

Wilson, J. L. (2014). Clinical perspective on stress, cortisol and adrenal fatigue. Advances in Integrative Medicine, 1(2), 93-96.

He, Zheng, et al. “High-fat Diet and Chronic Stress Aggravate Adrenal Function Abnormality Induced by Prenatal Caffeine Exposure in Male Offspring Rats.” PubMed Central (PMC), 1 Nov. 2017,

Valk, Eline S. van der, et al. “Stress and Obesity: Are There More Susceptible Individuals?” PubMed Central (PMC), 16 Apr. 2018,

Cay, Mahmut, et al. “Effect of Increase in Cortisol Level Due to Stress in Healthy Young Individuals on Dynamic and Static Balance Scores.” PubMed Central (PMC), 29 May 2018,

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