What is Adrenal Fatigue? And should I be concerned about it?

What is Adrenal Fatigue? And why does everyone seem so concerned about it?

It seems very trendy these days and you keep hearing that your friend, colleague, family member, and/or boss were diagnosed with Adrenal Fatigue!

One of the most common reasons patients come to see me is to get help with their low energy after seeking for help for months and being told by many practitioners that this is only in your head, or you are depressed. Adrenal fatigue is real and is one of the most common and under-diagnosed  hormone imbalances. The main reason why it is rarely diagnosed is because in mainstream health care there is no real evaluation or testing for adrenal fatigue.  Most providers are not looking for it and never get to the root of what is really going on. Blood tests focus on adrenal failure and not adrenal fatigue. Unfortunately 90% of the glands must be destroyed before you will be able to see it in the blood work.

Fatigue is common in our society and for good reason. We are constantly pushing ourselves to work harder, to perform better, or to get more done in the day. You can call it burnout, chronic stress, or exhaustion. If we compare ourselves to our technology free ancestors, clearly we can see that  21st century is taking a toll on our health. Symptoms of adrenal fatigue are far more common than we realize in our constantly on-the-go lifestyles.

Are you feeling tired and fatigued every day? Do you have difficulty waking up in the morning no matter how many hours of sleep you get? Do you have a weak immune system? Difficulty handling stress? Craving salty and sugary food? Consuming too many stimulants, caffeine or alcohol? Are you suddenly having high blood pressure? Having trouble falling asleep or staying asleep? Feeling anxious, irritable, or having difficulty tolerating people?

If you are experiencing any of the above symptoms then it is time to check your adrenals. Your adrenals may be crying out for help. Do not get mislead by getting misdiagnosed with depression, anxiety, OCD, or bipolar disorder. While these are all real issues, it is important to dig further to find out the root cause of your symptoms.

What are the adrenal glands?

The adrenal glands, two small size glands which sit above the kidneys, are responsible for managing and responding to stress. They secrete a number of hormones that you cannot live without,  including adrenaline, noradrenaline, cortisol, DHEA, and aldosterone.  The output of some of these hormones varies during the day and night, called a circadian rhythm. For example, cortisol is supposed to be higher in the morning and lowest at night. However, if they are never given a break from the daily stress they can become fatigued.

The primary goal of the adrenal glands is to manage stress.  Stress should be something we experience only over a short time, but these days stress is continuous. Adrenal glands also influence sleep, mental vitality, energy, recovery from illnesses, and the growth and repair of bone, skin, and muscle.  Additionally, they regulate blood sugar and insulin levels, blood pressure, mineral balance, thyroid and sex hormone levels, and immune function.

When you are under stress continuously and you are not giving any break to your adrenals, the “fight- or- flight ” system stays on. If you don’t sufficiently rest and recharge, your adrenals will become overtaxed, causing your cortisol levels to drop. This is where most people begin to notice there is a problem. Your adrenal glands continue to release adrenaline and cortisol at high amounts and you are left feeling run down, irritable, nervous, and on edge. Your heart rate and blood pressure remain elevated and your digestion, immune system, and sleep will all be negatively affected. As stress persists, the adrenal glands become fatigued and their ability to produce hormones suffers. Because of this, your body will not be ready to encounter a new stressor.

Cortisol is the main hormone secreted during stress. Stress can be physical, emotional, mental, or physiological. Do not underestimate the impact of emotional stress. For example, loss of a loved one can hit 1000 times more adrenals compared to physical stress. Cortisol is released by the adrenal glands to allow for a more sustained response to stress.  It increases glucose levels in the bloodstream and enhances brain and muscle usage of glucose as a source of fuel.  Cortisol also increases the availability of building blocks used to repair the body and suppresses immune, digestive, reproductive, and growth processes.  Non-essential systems are shut down in favor of enhanced thinking, movement, and energy production. As one of my patients said on her first visit “Every little stressor feels like the end for me!”

How to test?

Testing is usually done by taking four saliva or urine samples over the course of a day. This maps out your circadian rhythm, showing how your cortisol levels rise and fall throughout the day. Urine is collected at first thing in the morning upon waking, then after breakfast, before dinner, and then before bed. Saliva is collected at approximately four-hour intervals: first thing in the morning upon waking, then at noon, late afternoon, and again at night before going to bed.

General Rules for Adrenal Fatigue:

As you can see, the adrenal glands affect many processes within the body.  Ensuring that these glands get the support they need is vital for health maintenance. While it is not always possible to take away the stressor, by making a concerted effort to address your basic needs on a regular basis, one may find that the burden of that stress can be carried without becoming reactionary or craving those comforts. Use the list as a reference guide and adapt and modify where necessary. Remember our adrenals love routine.

Below are some general rules to follow to help you recover from adrenal fatigue.

–       Be in bed by 8:30 PM and Sleep in until 8:00 AM whenever possible.

–       Eliminate energy robbers (things in your life that drain your energy)

–      Take your dietary supplements regularly. See the list

–       Move your body and breathe deeply. Gentle walking and nothing excessive

–       Rotate food and be aware of your food sensitivities

–       Combine carbohydrates, proteins and healthy fats (oils) with every meal.

–       Do not skip breakfast- intermittent fasting is not allowed here

–       Avoid becoming overtired

–       Avoid caffeine, sugar, alcohol and white flour products.

–       Never eat starchy carbohydrates (pastas, breads) by themselves

Ensuring that you meet your body’s basic needs with air, water, food, sleep, movement, and intimacy is one way to support adrenal function.  Additional ideas include:

Supplements– Extra Nutrients – The adrenal glands require sufficient intake of vitamins (A, C, E, B6) and minerals (zinc, manganese).  Vitamin C and B5 are food for adrenals, B5 plays a major role in in the production of adrenal hormones especially in high stress situations

Herbal remedies, taken as teas, liquid extracts, or capsules, can also improve adrenal function and reduce stress.

Adaptogens – Adaptogenic herbs can be useful if you’re struggling with persistent stress, Ashwagandha- Normalizes cortisol levels – if too high decreases. Rhodiola – Very beneficial for your nervous system. It has antidepressant and anti-anxiety benefits, and has been shown to help in those situations that you feel very overwhelmed educe symptoms of burnout associated with work stress. Ginseng (Asian and Siberian), Tulsi.

Calming herbs–Skullcap and passion flower – dampen stress response, anxiolytics – good for stress in the head/mind

Relaxation Techniques – Meditation, yoga, Tai chi, deep breathing exercises, journaling, and counseling are great for stress management.

Take the power and responsibility of your health into your own hands. Make whatever lifestyle changes necessary to regain your health


I hope these tips help you in managing your adrenal fatigue symptoms. I am happy to help you further with proper testing and diagnosis.


Dr. Sara Zare ND

Contact me today to schedule a consultation and complete adrenal testing: 415-590-2899



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