Understanding Adrenal Fatigue

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The Pure TheraPro Team

The Pure TheraPro Education Team is comprised of researchers from diverse backgrounds including nutrition, functional medicine, fitness, supplement formulation & food science. All articles have been reviewed for content, accuracy, and compliance by a holistic integrative nutritionist certified by an accredited institution.
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Did you know that 75-90% of primary care visits are related to stress? 

Stress-related symptoms that patients report include insomnia, stomach upset, headaches, depression, anxiety, heart palpitation, fatigue and more.

Although Western medicine does not accept “adrenal fatigue” as a diagnosis, imbalance in what is known as the hypothalamic-pituitary-adrenal circuit (HPA) may cause an array of symptoms commonly classified as adrenal fatigue.

A chronic stress response on your system will eventually lead to health issues, even serious ones, such as heart disease, diabetes, autoimmune disease and an accelerated rate of aging.

The adrenal glands are located above the kidneys and produce several different hormones, such as cortisol, dehydroepiandrosterone (DHEA), aldosterone and the sex hormones, testosterone and estrogen.

The hormone most connected to the stress response is cortisol. When your body undergoes prolonged exposure to stress, cortisol levels increase, which in turn, causes a domino effect in your system—Cortisol increases blood pressure, blood sugar levels and instigates the immune system.

DHEA, also managed by the adrenal glands, helps to counteract the negative effects of prolonged cortisol levels—the two hormones work together in a check in balances fashion. DHEA levels, however, diminish with age and also are thrown off balance by chronic stress and other environmental and internal factors.


Appropriate levels of cortisol produced by healthy and functioning adrenal glands provide us with ample energy to face daily stress, to endure an Insanity workout, climb a mountain or face a sudden trauma with resilience. When stress is overwhelming or chronic, the psycho-emotional stress may alter this delicate hormonal balance of the HPA circuit, otherwise known as adrenal fatigue.

Chronic stress will eventually numb the response of your immune system. Think of the story of The Boy Who Cried Wolf. Repeated warnings will eventually result in the body no longer responding to the cries for a stress response. This leaves your immune system vulnerable to infection, pathogens, parasites, viruses, and one of the reasons why people get more colds and flu when they are overwhelmed by stress.

Healthy adrenal function provides you with multiple benefits. It promotes fat burning and metabolic function, directs important anti-inflammatory agents in your gut, balances your mood and blood sugar levels, guards you from inflammation, regulates water retention and electrolyte balance.

When your adrenal glands function properly, you wake up refreshed with ample energy to sustain your daily tasks. Your body doesn’t store fat around your midsection. You sleep well at night, don’t feel as if your body is chronically inflamed.

If you have the following symptoms, however, your adrenal glands may have reached their limit, causing an imbalance in cortisol levels:

*Feeling “wired but tired”, chronic fatigue, exhaustion

*Insomnia, difficulty getting to sleep or staying asleep, waking up exhausted

* anxiety, depression, mood swings and irritability

*gut issues-Leaky Gut Syndrome, gas, bloating

*blood-sugar level imbalances

*weight loss resistance in spite of diet and exercise

*hypothyroidism/thyroid abnormalities

*Suppressed immune function—frequent colds, flu, infections

*Decreased serotonin levels

*Estrogen dominance

*Vitamin/mineral deficiencies

*High blood pressure

*Skin issues/acne

*Muscle/bone weakness

*Hair loss

*Brain fog/memory loss

*Low libido

Cortisol’s main role is to provide us with energy when we are in crisis. It does this through a process known as gluconeogenesis, which secretes sugar (glucose) in the bloodstream for the body to utilize as energy. This process automatically shuts off when the crisis is over through various signals to the brain and throughout your system. With chronic stress, however, this feedback loop never shuts off. Cortisol eventually begins to affect every tissue in the body.

Too little cortisol can also cause issues. Eventually, stress can affect cortisol production and deplete the body. This may result in metabolic issues, fatigue and chronic health issues.

Healthy adrenal function also involves a regulation of cortisol secreted throughout the day, which establishes a circadian rhythm that is aligned with nature. As the sun rises, cortisol levels should rise, as well; Diminished levels are secreted at night, allowing proper sleep and rest. When this natural rhythm is disturbed, you may notice high energy levels at night and a crash during the day.

Your adrenal glands are sensitive to both internal and external stressors. Surgery, grief, a bad breakup/divorce, work-related issues, chronic illness—all may lead to cortisol imbalance. Even food allergies, crash dieting or bingeing on alcohol and processed foods can lead to adrenal issues. Parasites, bacteria and pathogens, biotoxin illness, chronic exposure to toxins and systemic candida infections all may contribute and complicate adrenal fatigue.

Adrenal fatigue happens over time, the effects of stress and the chemicals released cascading in recognizable stages. This syndrome is known as General Adaptation Syndrome (GAS)

1. Alarm Reaction: The initial phase of Adrenal Fatigue begins with feeling exhausted after a constant “Fight or Flight” mode due to high cortisol levels. Heart rate may be elevated along with blood sugar levels and blood pressure. This may result in initial weight gain due to insulin resistance along with sleep disruption, anxiety and digestive issues.

2. Resistance or Adaptation: If unmanaged, circulating cortisol levels may begin to be depleted along with DHEA. Symptoms become more exacerbated—chronic fatigue, weight gain, food allergies. Rather than high blood pressure, lowered levels of cortisol now result in low blood pressure along with thyroid abnormalities, slow metabolism and food cravings, such as salt, due to mineral deficiencies and electrolyte imbalances.

3. Adrenal Fatigue/Insufficiency: Extremely low cortisol and DHEA levels cannot provide the body with adequate hormones and energy. In this phase, a feeling of exhaustion/chronic fatigue begins with a feeling of unrest even after multiple hours of sleeping. Memory becomes impaired, physical symptoms increase, such as fluid retention, dark circles under eyes, puffy hands and face, depression and anxiety increase along with other signs of accelerated aging. Chronic illness, such as autoimmune disease, Leaky Gut Syndrome, heart disease may surface.

Blood tests won’t accurately measure cortisol levels because it is just a snapshot of your cortisol in your bloodstream at that one moment. More accurate testing of adrenal hormones may be done through saliva or urine testing occurring at various times throughout a day to also check for proper circadian rhythm functioning of hormone secretion.

Getting your hormones back in sync may take a while, even up to a couple of years, depending on the severity. Recovery involves removing stressors, healing gut issues, addressing vitamin and nutrient deficiencies as well as other endocrine imbalances.

REDUCE STRESS: Although it’s easier said than done, removing the stressor is a logical first step to reducing stress. Finding better ways to manage stress is also important. Getting exercise, connecting with nature, spending time with friends, meditating and focusing on gratitude and mindfulness all help to manage stress. Engaging in hobbies that bring you passion or exploring new ones also help take focus off the negativity in our lives and improve quality of life.

SLEEP: What time are you currently going to bed? If it’s past 11 PM, you may want to alter your sleep schedule to be more in line with our natural circadian rhythm. Early to bed, early to rise helps the body repair and regenerate. Your bed sleep hours are between 10 PM and 6 AM.

Limit screen time before bed and set your wifi to Airplane Mode, which reduces EMF exposure and frequency that prevents an optimal sleep cycle. Studies are showing that cell phones may affect deep non-REM sleep, leading to poor concentration, fatigue, memory issues and hormonal disruption.

“Anything that disrupts the integrity of your sleep will potentially have adverse consequences in functioning during the day, such as grouchiness, difficulty concentrating, and in children hyperactivity and behavior problems,” says Dr. William Kohler of the Florida Sleep Institute.

Supplementing with amino acids, the neurotransmitter gamma-aminobutyric acid (GABA) to manage stress and inositol can help quiet your central nervous system, improve sleep quality and reduce anxiety.



Since cortisol levels affect blood sugar levels, it’s important to avoid support your adrenals by eliminating processed foods, alcohol and grains. Healthy fats help promote hormone balance, so load up on avocados, coconut oil, grass-fed, organic meats and wild-caught fatty fish, which help to naturally regulate blood sugar.

Leaky Gut Syndrome and adrenal fatigue often go together. Stress impairs proper digestion and disrupts your gut microbiome, leading to increased gut inflammation and the opportunity for parasites, bad bacteria and pathogens to inhabit your gut. This inflammatory response affects the HPA circuit, leading to more disruption and imbalance with hormones, neurotransmitters and immune function.

Adaptogenic herbs such as licorice root intuitively influence cortisol levels and regulate the HPA axis, increasing or decreasing hormone levels based on the body’s individual needs. Licorice root also has anti-viral, anti-bacterial and anti-parasitic properties to help optimize the gut microbiome by attacking pathogens that disrupt a healthy microflora.


Probiotics impact cortisol levels, according to a randomized clinical trial. Taking a multi-strain probiotic daily helps manage appropriate cortisol levels, reduce inflammation and regulate immune function. This evidence points to the connection between the gut microbiome and central nervous system. 


Supplements that may help adrenal fatigue include B vitamins, vitamin C, zinc, CoQ10, magnesium and fat-soluble vitamins, such as vitamin D.

B Vitamins:

Methylated forms of B vitamins help to boost energy levels and are important to cell metabolism. B vitamins are also responsible for cellular respiration and the breakdown of fats, proteins and carbohydrates, which may help promote weight loss if you have adrenal fatigue.


Vitamin C:

The adrenal glands contain one of the highest concentrations of Vitamin C in the body. Packed with antioxidant properties, vitamin C helps your adrenals produce cortisol, and optimal levels are necessary to recover from adrenal imbalances. It is recommended to begin with 1000 mg of vitamin C daily, and gradually increase the dose. Look for liposomal vitamin C, which provides greater bioavailability.  

Vitamin D:

Fat soluble vitamins such as vitamin D work affect hormones, helping to stabilize your metabolism and other endocrine functions. Low levels of vitamin D have been linked to cortisol overproduction.

Optimal levels of vitamin D are between 50-70. Vitamin D also help to elevate mood, boost energy and the immune system as well as promote healthier bones and cardiovascular function.



Approximately 75% of Americans are deficient in magnesium. Magnesium helps maintain energy levels and alleviate symptoms such as anxiety and depression, which are associated with Adrenal Fatigue. The Recommended Daily Allowance for magnesium is 250-300 mg a day for women; men need more, about 400 mg daily. Choose bioavailable forms of magnesium that are gentle on the stomach, such as magnesium malate and magnesium glycinate.




CoQ10 feeds cells down to the mitochondrial level, helping promote energy, exercise endurance, as well as optimal brain and cardiovascular function. Food sources for CoQ10 include organ meats, beef and certain fish, but supplementation may be necessary to boost energy levels if you have Adrenal Fatigue.



In spite of allopathic medicine’s denial of Adrenal Fatigue as a diagnosis, HPA axis dysfunction can affect multiple bodily systems, disrupting metabolic and endocrine function, bone health, an optimal gut microbiome, strong immune system, energy levels, cognitive health and more. Everything in our body is connected. When one element of the body is out of sync, it can cause a cause-effect relationship throughout multiple systems that affect our health and wellness. Supporting your adrenals is critical to feeling like yourself again—rested, energized, happy and healthy.