Our survival often depends on our ability to handle short-term stressors, like running from a hungry lion, for example. However, our bodies need the stressors to end, so they can return to normal functions and rest and repair. When the stress continues long-term, it can begin to cause serious health problems. Of these more serious conditions is adrenal exhaustion. This article will look at what adrenal exhaustion is, the symptoms, and what you can do about it.
To understand adrenal exhaustion, it is important to understand what happens in your body during stress and how this can build up to adrenal exhaustion.
During short-term stress, your adrenal glands, two glands on top of your kidneys, produce stress hormones that help you to respond to the stress. The main stress hormone is cortisol. When the stress subsides, the adrenal glands stop producing cortisol.
The NeuroEndoMetabolic (NEM) Stress Response System consists of six circuits of related organs and systems that help support your body during stress. One of these circuits is the Hormone circuit. This circuit is responsible for regulating the hormones in your body and consists of your adrenal glands, thyroid gland, and reproductive organs.
When stress becomes chronic, your adrenal glands continue to produce cortisol. Over time, this depletes the resources your adrenals need to make adequate hormones. This can start to cause imbalances within the circuits of the NEM system. The symptoms will depend on where the imbalances in the NEM system are. This is the reason why there can be a range of different symptoms of stress.
This state is a condition known as Adrenal Fatigue Syndrome (AFS), the non-Addison's form of adrenal dysfunction, where the body's stress response cannot keep up with life's chronic stressors.
In AFS, there are four different stages. Adrenal exhaustion is the third stage of AFS. This is when the production of cortisol declines significantly and starts affecting multiple different circuits within the NEM system.
However, while cortisol production is low, the body still produces some cortisol, unlike in Addison's disease where no cortisol is produced at all.
Determining the root cause of adrenal exhaustion is important. However, there are many different potential causes of adrenal exhaustion, which can make them difficult to pinpoint. These causes include:
There are many different symptoms of adrenal exhaustion. However, not everyone experiences all of these symptoms. Some may only experience a few, or they may experience other symptoms that are not on this list.
This is the number one symptom most people complain of. The body is often unable to get proper rest due to high levels of cortisol in the early stages of adrenal fatigue, and norepinephrine and epinephrine in the later stages keep the body amped up and unable to relax properly to rest. One sign of adrenal exhaustion is a severe mid-afternoon slump followed by a 2nd wind in the early evening.
In addition to keeping the body alert and from getting proper rest, the consistently high levels of these stress hormones disturb the body’s daily rhythm, making it hard to go to sleep at the right time and to stay asleep throughout the night. The entire 24-hour cycle is disrupted. The more advanced the AFS, the more frequently nighttime awakening can occur. Sometimes this is accompanied by heart palpitations and sweating. This is a sign that the body’s fight-or-flight response is on full throttle, and metabolic derangement can occur.
In the early stages of adrenal fatigue, blood pressure can be higher than normal. During the later stages, the weakened adrenals put out lower amounts of cortisol, which helps regulate blood pressure, and therefore, blood pressure tends to drop.
Cortisol, released by the adrenals, also plays a key role in controlling histamines, the major hormone in allergic reactions. When cortisol levels become lower, the histamines exert a greater effect. This exaggerates existing allergies and flares up some that were not a problem before. Skin problems, bloating, and food sensitivities often worsen when this occurs. Suppressing the allergies with medication does not solve the problem and only leads to dependency issues further down the road. Nurturing the adrenal glands back to optimum health remains the foundational approach that helps the body heal itself over time.
Metabolism can be affected by Adrenal Fatigue Syndrome. This can lead to poor thermal regulation and a lower body temperature than normal. Low body temperature, despite being put on thyroid replacement medication, is a classic sign that the low metabolism and fatigue experienced is not due to a primary thyroid problem, but rather a condition of low thyroid function caused by adrenal gland weakness.
The decline in the functioning of the adrenal glands causes imbalances in other hormones throughout the body, including those regulating the female reproductive cycle. Because many of these hormones share the same precursor hormones, an excess demand for cortisol can deplete the resources needed to make adequate levels of other needed hormones, like estrogen, progesterone, and testosterone.
The adrenal glands are also responsible for secreting aldosterone, an important hormone that helps regulate salt and hydration levels in the body. Aldosterone is generally low in those with AFS, which lowers the amount of sodium in the body. If you find that you are constantly thirsty and have a need to carry a water bottle around, this may also be an adrenal exhaustion symptom.
Sodium imbalance in the body creates its own set of problems which, at their most severe, can include cardiac problems.
Low cortisol levels hamper the body’s ability to convert glycogen, fats, and proteins into new glucose supplies, leading to a faster drop in blood sugar after eating.
These and more symptoms form a dizzying array of afflictions that can be hard to decipher for even a medical professional. As AFS progresses, many symptoms can change in severity and new symptoms can arise. The important thing to remember is that the symptoms can all be interconnected, and there may not be any need to isolate and treat them as different conditions.
If your healthcare provider is concerned that you may have adrenal exhaustion, you may be sent for some tests. These tests include measuring the amount of cortisol in your urine, blood, or saliva. Saliva-based tests can measure the amount of hormone that is not bound to any proteins in your body, which is the free and active form of cortisol in different points throughout the day. It may be best to do several cortisol tests over the course of the day, because cortisol naturally fluctuates throughout the day. Blood tests can test for free cortisol, but it's difficult to go to the laboratory to get poked 4 times throughout the day. Saliva testing is done in the comfort of your own home and can be sent out via mail. Those with later stages of adrenal fatigue or adrenal exhaustion might see their saliva curve be flat, meaning they don't really produce morning cortisol, and their cortisol throughout the day is also low. This is classic for adrenal exhaustion. However if your cortisol is high at points throughout the day that doesn't rule out adrenal exhaustion either. You want to have a whole person view of your symptoms in addition to the testing to be able to fully understand adrenal exhaustion.
Adrenal exhaustion is complex and needs to be carefully monitored. Whilst it is recommended to seek professional guidance if you are concerned that you may have adrenal exhaustion, some remedies at home may help to relieve the symptoms of adrenal exhaustion and nurture your adrenal health.
A poor diet, one high in refined carbohydrates, processed foods, and sugar, can contribute to adrenal problems. Vitamins and minerals are vital nutrients that help to support your adrenal functioning. Some notable vitamins and minerals that can help support your adrenals include:
A 2023 study focusing on nutrients, suggested that vitamin C plays an important role in the regulation of cortisol production, whilst vitamin E plays an important role in the activity of the adrenal glands. This study also highlighted the importance of these along with zinc and selenium in not only assisting in supporting the adrenal glands but also helping to reduce inflammation that can occur in adrenal exhaustion (1).
Vitamins and minerals are required by your body daily. Different grains, fruits, and vegetables will contain different nutrients. Therefore, a varied diet with different grains, fruits, and vegetables is important. A simple tip to help your diet to become varied is to ensure that your plate is colorful, as the different colors of fruits and vegetables are associated with different nutrients.
Alcohol can also place stress on your body and can contribute to adrenal exhaustion. The general recommended limit for alcohol is one drink daily for females and two for males. However, if you are currently experiencing adrenal exhaustion, it may be best to abstain.
The timing and frequency of meals are also important. To provide steady blood sugar and energy levels, which can fluctuate with adrenal exhaustion, it's recommended that you have small, frequent meals throughout the day. This typically includes three meals a day with an additional two snacks, one between each meal if necessary.
Gentle movement such as yoga can be an effective method to help relax the body and to support the adrenal glands. Hot yoga and vinyasa yoga may be too strenuous on the body; however, restorative yoga can be a better fit. If you do try yoga, try to avoid any poses involving backbends and standing postures as they can stimulate your adrenal glands.
One study suggested that 90 minutes of yoga stretching can help to activate your rest and digest nervous system and reduce cortisol levels; however, more research is necessary on whether or not shorter periods of yoga stretching will give the same results (2).
If yoga is not your preferred choice of exercise, walking or even cycling can help. However, these should be at a leisurely pace. Avoid strenuous exercise with adrenal exhaustion, as this can demand more cortisol from your already depleted adrenals.
Whilst breathing can be included in yoga, it can also be practiced by itself help to relax your body.
Different types of breathing will activate different nervous system responses in your body. Breathing through your mouth can activate your fight and flight nervous system, whilst breathing through your nose can activate your rest and digest nervous system and help to calm the body.
One recent study involving breathing techniques found that practicing breathing techniques such as diaphragmatic breathing and nose breathing could effectively help to reduce cortisol levels, thus potentially reducing stress on the adrenals (3). However, whilst this study is promising, the breathing exercises were done along with exercise and meditation. Therefore more studies researching the singular effect of breathing are necessary.
There are many different supplements, including some specifically for adrenal exhaustion. Adrenal Daily Nutrient by Dr. Lam is one supplement that contains a variety of blends that can work to support your adrenal glands. The blends include a digestive, superfood, immunity, cleansing, and adrenal blend. The adrenal blends consist of many different nutrients that will work to support the adrenal glands. These nutrients include:
Whilst the other blends are focused on different functions, some of the ingredients in these blends are also designed to support the adrenals, such as probiotics (1). Other products by Dr. Lam that can also help to support your adrenals include Liponano C and Pandrenal.
However, do note that if you are experiencing adrenal exhaustion, your body can become very sensitive to new products and have paradoxical reactions. This makes it important to always check with your healthcare provider before you try a new product.
Adrenal fatigue syndrome (AFS) is indeed a complex condition that requires a multifaceted approach for management. The symptoms you've mentioned can greatly impact one's quality of life, so it's crucial to address them effectively. Strategies like quality nutrition, supplementation, gentle physical activity, and breathing techniques can certainly contribute to relieving symptoms and supporting adrenal health.
However, as you mentioned, it's essential to identify the root cause of adrenal exhaustion. This often involves a comprehensive assessment of lifestyle factors, stressors, dietary habits, and medical history. While self-care strategies are valuable, personalized guidance from healthcare professionals can offer tailored support and ensure a more effective recovery plan.
Dr. Lam's Nutritional Adrenal Fatigue Recovery Program is a comprehensive resource for those seeking structured guidance in managing adrenal fatigue. With a focus on meal planning, exercise, supplementation, and recovery strategies, it provides a roadmap for individuals to navigate their healing journey.
For those experiencing symptoms of adrenal exhaustion and seeking support, getting Dr, Lam’s Nutritional Adrenal Fatigue Recovery Program can also get you access to a free initial phone consultation with Dr. Lam’s team to help you understand your condition better and access personalized recommendations for adrenal fatigue recovery.
Support Your Adrenal Health
Patani A, et al. "Harnessing the Power of Nutritional Antioxidants Against Adrenal Hormone Imbalance-Associated Oxidative Stress." Front Endocrinol (Lausanne), vol. 14, 2023 Nov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10720671/#:~:text=Vitamin%20C%20has%20been%20demonstrated,generated%20by%20the%20adrenal%20glands.
Eda N, et al. "Beneficial Effects of Yoga Stretching on Salivary Stress Hormones and Parasympathetic Nerve Activity." J Sports Sci Med, vol. 19, no. 4, 2020 Dec. pp. 695-702. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675619/
Obaya HE, et al. "Effect of Aerobic Exercise, Slow Deep Breathing and Mindfulness Meditation on Cortisol and Glucose Levels in Women with Type 2 Diabetes Mellitus: A Randomized Controlled Trial." Front Physiol. vol. 14, 2023 Jul. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373883/
Anyone can experience adrenal exhaustion. Individuals who are at risk for developing adrenal exhaustion, are those who have a poor diet, those who either over-exercise or who do not exercise, individuals who are frequently sick, those under chronic stress, and those who are exposed to smoke and chemicals.
