Adrenal fatigue
Eating to support your adrenal glands — small choices can
make a difference
by Marcelle Pick, OB/GYN NP
Fatigue is one of the most common symptoms I hear about from my patients at the
clinic. And when I ask these women to tell me about what’s going on in their
lives, all too often the answers include more responsibility than seems humanly
possible. They’re waking up still tired, unable to think straight in the morning
without caffeine; needing high-carb snacks, more caffeine, or a nap to get through
the afternoon; then burning the midnight oil because they’re too wired to
sleep. Pretty soon these women are in a seemingly unending cycle of exhaustion and
poor nutrition — and they feel desperate for the energy they once had.
Science tells us that if you experience stress on a chronic basis, the tiny adrenal
glands that moderate your stress response and balance many other hormones in your
body will suffer. Adrenal fatigue is what develops. And as the adrenal glands become
increasingly compromised, women end up with excess abdominal weight, decreased immunity,
lack of concentration, irritability, disrupted sleep, and ultimately, pure exhaustion.
But the upside is: adrenal fatigue can be prevented and reversed. I’ve seen
it time and again. And one of the best places to start is by paying closer attention
to the choices you make about food — and not just what you eat, but when
you eat it and how.
From my own experience and that of my patients, I know it’s difficult to make
good nutritional choices when we’re going through periods of stress. Not only
are our minds preoccupied with the stressor at hand, but our bodies are telling
us they desperately need support, so we reach for foods that provide quick energy.
Particularly at the end of a stressful day as the body is entering a period of recovery,
overeating or making poor choices can be easy to do.
I know it feels overwhelming to think about changing your eating patterns, but believe
me, small, incremental changes can really support better adrenal gland function
and your daylong energy reserves. You don’t have to drag through the long
days or dread your alarm clock every morning. Let’s look at some options for
supporting your adrenals — so you can enjoy good energy all through the day,
and get a great night’s sleep. The difference can be like night and day!
Your foundation rests on adrenal health
As the great balancer of more than 50 hormones in the body, the adrenal glands have
a broad impact on your health and energy. The adrenals are primarily responsible
for activating your stress (“fight or flight”) response, shifting energy
away from restorative processes like digestion and toward the organs of action —
your heart and skeletal muscles — by pumping adrenaline and cortisol into
your bloodstream. But they also synthesize numerous other hormones, including androgens
and their precursors, such as testosterone and DHEA, as well as estrogens and progesterone
— which is why it becomes more important than ever to support our adrenal
glands as we approach menopause, a time when our bodies come to rely more heavily
upon the regulation of hormones.
But aside from the life-critical job the adrenals play in activating your stress
response and supplementing healthy hormonal balance as we age, the hormone cortisol
itself has a powerful hand in so many other regulatory processes across all your
systems: protecting the body from stress by regulating blood pressure,
normalizing blood sugar levels, helping to regulate the immune and inflammatory
responses, and influencing mood, memory, and clarity of thought.
Maybe this helps explain why, when your adrenal reserves are depleted, you might
feel a little crazy, and your sleeping and eating habits seem a little crazy, too!
In Ayurvedic medicine, the adrenal glands are connected to the “root”
chakra and contribute to our groundedness, nourishment and physical health. With
persistent stress, we become increasingly less grounded, which can increase stress
even more — and the constant demand for stress hormones means the adrenals
become depleted and ultimately exhausted.
But my experience with women over the years has shown me that you can provide stronger
grounding and support to the adrenal glands by making some simple choices when it
comes to eating and nutrition. Will your food choices make or break your adrenals?
Not exactly — stress is the number-one major offender when it comes to adrenal
depletion, and you can read more about this in our article on
stress and the effects of high cortisol — but good nutrition, well-timed
meals and snacks, and sometimes a gluten-free diet can significantly relieve the
strain on your adrenal glands.
Think about the tires of a car. If you buy good quality tires and routinely check
their air pressure, balance and rotate them, and patch any holes, the foundation
for how your car moves on the road will be safe, steady, and strong. You’ll
get better gas mileage, the car will respond better when road conditions are slippery
or uneven, and the car will last longer. The same goes for adrenal function. Selecting
high-quality foods, building a strong nutrient base, and paying attention to when
and how you eat all make for more efficient and healthy adrenal function —
and better health all around. Just as neglecting your tires may not immediately
compromise your safety or your car’s efficiency, your adrenals can take a
lot of strain before you begin to see the effects on your body.
First and foremost: timing your meals and snacks
One thing I often tell my patients is to never allow themselves to get too hungry.
Low blood sugar by itself puts stress on your body and can tax your adrenals. You
may not realize that your body is in constant need of energy — even as you
sleep. And the primary adrenal hormone cortisol serves as a kind of moderator in
making sure your blood sugar between meals, especially during the night, stays adequate.
It does this by signaling to the liver to release its stored sugar, glycogen,
when there isn’t food on board. Long periods without food make the adrenals
work harder by requiring them to release more cortisol to keep your body functioning
normally. So eating three nutritious meals and two to three snacks that are well-timed
throughout the day is one way to balance your blood sugar and lessen the adrenal
burden.
When you eat can also make a difference in preserving, supporting, and
restoring your adrenals. As you can see in the graph, cortisol has a natural cycle
that works with your circadian rhythm. Normally, it begins to rise around 6:00 AM
and reaches its highest peak around 8:00 AM. Throughout the day cortisol gradually
declines — with small upward bumps at meal times — in preparation for
nighttime rest.

It’s ideal to work with this natural cycle to keep the tapering-off of levels
as smooth as possible as the day progresses and to avoid dramatic ups and downs.
To do this, it helps to get the majority of your food in earlier in the day, and
to eat an early dinner (by 5:00 or 6:00 PM). If it’s difficult to eat early,
as it is for many of my busy patients, at least try to make your evening meal the
lightest one of the day, to prevent a surge of cortisol from ramping up your night-time
metabolic rate and disrupting your ability to fall or stay asleep. Many of my patients
tell me they overeat to soothe themselves in the evening. This “night-eating”
habit is due to the appetite-stimulating effects of residual cortisol, and unfortunately,
it only further disturbs our hormone axis.
Keep in mind that cortisol will also rise a bit with exercise. Lighter activities,
such as a walk after dinner or a bit of gentle stretching before, will not subvert
this natural tapering-off process. But to work in concert with your body’s
natural cortisol cycle, more intense exercise is best planned for the morning.
But I’m not hungry in the morning...
As your mother probably told you, breakfast is important. But maybe you don’t
feel hungry in the morning, and if so, it could be for the following reasons:
- Corticotrophin-releasing hormone (CRH), which has appetite-dulling effects,
begins to enter the bloodstream at a fast rate first thing in the morning.
- Decreased liver function, which can accompany adrenal dysfunction or a heavy toxic
burden, can also dampen morning hunger.
Even if you don’t feel hungry, having a nutritious breakfast within an hour
of rising — preferably with protein — will provide energetic benefits
to your metabolism and cortisol levels that last throughout the day.
Here are some other simple ways to gently support your body’s natural cortisol
cycle:
- If possible, eat breakfast by 8:00 AM or within an hour of getting up (earlier is
better), to restore blood sugar levels after using glycogen stores at night.
- Try to eat lunch between 11:00 AM and 12:00 noon. Your morning meal can be used
up quickly.
- Eat a nutritious snack between 2:00 and 3:00 PM to get you through the natural dip
in cortisol around 3:00 or 4:00 in the afternoon.
- Make an effort to eat dinner around 5:00 or 6:00 PM, and make this your lightest
meal of the day.
Supporting your body’s natural rhythms by timing meals and preventing dramatic
dips in blood sugar not only minimizes cortisol output and frees up your adrenals
to perform their secondary functions, but gives you more sustained energy throughout
the day — and life becomes much more enjoyable when we have the energy we
need.
Eat, drink, and support adrenal gland function
As our awareness about when we eat increases, it’s also helpful to
think more about what we eat. Stress often brings out the worst in us — especially
when it comes to food choices. Many of my patients with adrenal fatigue tell me
they reach for foods that give them an instant burst of energy — foods like
cookies, cakes, doughnuts, white bread or pasta. These foods contain refined sugar
and flour, and allow a great surge of energy, but generally the surge is followed
by an even greater dip in energy, causing you to feel worse.
Another problem with high-carb foods like these is that they often contain gluten,
a protein that is found in many grains (including wheat, rye and barley, and oats)
and frequently used as a food additive, too. I have found in my practice that many
women with adrenal fatigue are sensitive to gluten. For this reason, a gluten-free
diet is one of the first things I suggest to my patients with
symptoms of adrenal fatigue, who often report feeling much better when they
get the gluten out of their diets.
Other women with adrenal fatigue drink more and more coffee or soda throughout the
day to stay awake. They may think it’s not affecting their sleep patterns,
but research has linked higher caffeine intake to classic “night owl”
or “eveningness” behavior. (See our article on the
effects of caffeine for more info.) Caffeine can pick you up in the short
term, but it can also over-stimulate the adrenals, which only compounds fatigue
as it wears off.
If you find yourself craving caffeine — or sugar for that matter — it
may be that your cortisol is low, but it also simply may be that your body needs
to rest. I encourage you to honor your body’s request and take a break, instead
of winding it up another notch. Take a quiet moment and treat yourself to some deep breathing or a ten–minute
walk. And if drinking a cup of coffee is a relaxing part of your routine and you
don’t want to give it up, drink it in the morning with something nutritious
to eat, and add cream to dull the negative effects of caffeine.
Choosing adrenal-healthy beverages
Just as with food, your choices about drinks can either contribute support or strain on your adrenal glands. Here are some good and not-so-good choices.
Adrenal draining |
Adrenal restoring |
| • Drinks that contain caffeine |
• Ginseng [Panax sp.]
• Eleuthero/Siberian ginseng [Eleutherococcus senticosus]
(in the morning) |
| • Alcohol |
• Herbal teas like chamomile, passionflower, valerian |
| • Gatorade |
• Vegetable juice (with salt), like V-8 |
Every day we make choices about what we eat and drink. Some days those choices are
helpful for the body and other days — or meals — aren’t so helpful.
What I encourage you to focus on is balance. Nourishing your body with balanced
meals and snacks can do wonders for your energy and feed your adrenal health at
the same time. Yet, you don’t want to be so stuck on eating “right”
that you cause yourself more stress! I always tell my patients to eat their best
80% of the time. The other 20% is up to them.
Eating meals and snacks that are made of fresh whole foods, preferably organic or
locally grown, without colors, dyes, chemicals, preservatives or added hormones
are best to strive for. Including some protein in all your meals and snacks (especially
in the morning) will have a stabilizing effect on your blood sugar, which in turn
can help you overcome caffeine and sugar cravings. (For more information on eating
balanced meals, see our
Personal Program Nutritional Guidelines.)
To lessen the stress that often comes with trying to eat healthfully, think about
preparing nutritious foods on the weekends so you have them ready and available
on busy weeknights, or stop at a health food store to pick up some hot prepared
food. Don’t feel guilty if your food isn’t homemade every day in your
own kitchen. Guilt is the last thing your adrenals need!
Salt and adrenal fatigue
Women with adrenal fatigue often crave salt — and many of my patients are
surprised when I tell them to honor this craving. Yes, salt can increase blood pressure,
but low blood pressure (hypotension) is a very common sign of adrenal fatigue
— at all stages. If you feel lightheaded when getting out of bed in the morning,
standing up quickly, or getting up out of a bath or hot tub, you may very well have
low adrenal function, and including more salt in your diet could be helpful. But
try to make it good-quality, iodized sea salt.
Craving for salt in people with adrenal fatigue is complicated to explain, but in
a nutshell, it’s a result of low aldosterone. Aldosterone, a steroid
hormone produced by the adrenal cortex, is part of the complex mechanism that regulates
blood pressure in the body. Levels of aldosterone go up and down in much the same
diurnal pattern as cortisol does, and likewise go up as a normal response to stressful
situations.
Production of aldosterone by the adrenals depends on how much cortisol-stimulating
hormone (ACTH) is being sent from the brain. The brain takes its signals from the
amount of circulating cortisol — not circulating aldosterone — so high
cortisol tends to lower the brain’s ACTH production, which in turn decreases
aldosterone secretion, leading to lower blood pressure.
Another consequence of low aldosterone is electrolyte imbalance and cell dehydration,
which both have negative effects on almost all physiological reactions in the body:
aside from salt cravings, low blood pressure and lightheadedness, patients with
adrenal fatigue often experience an irregular heart beat, lethargy, muscle weakness,
and increased thirst. These are all a result of imbalance in sodium and other minerals,
including potassium and magnesium. Increasing your salt intake is one way to help
restore these imbalances.
A nutrient-rich foundation — essential for healing adrenal fatigue
If you decide to do nothing else for your adrenals, I urge you to provide your body
with a strong nutrient base. The vitamins, minerals and other micronutrients available
in a pharmaceutical-grade supplement like the one we offer in our Personal Program
are absolutely essential for healing adrenal fatigue — as well as for the
everyday workings of your adrenal glands.
If you need additional support for adrenal health
Our Essential Nutrients provide an optimal nutrient foundation for your adrenal
health. Yet some women need extra nutrient support for healing adrenal fatigue.
Here are my top recommendations:
- Ashwagandha (Withania somnifera)
- Eleuthero / Siberian ginseng (Eleutherococcus senticosus)
- Phosphatidylserine
- Licorice root (Glycyrrhiza glabra)
- Extra B vitamins (B-complex)
You can begin on your own with the first two herbs listed above. If you do not notice
improvement within a few weeks, see a functional medicine or naturopathic practitioner
for a program that best fits your personal needs — dosage, timing, blood pressure,
cortisol levels, and other factors should be taken in to consideration.
Vitamins like C, E and all the B vitamins have crucial roles in the reactions
that occur in the adrenal cascade. And a mineral like magnesium provides necessary
energy for your adrenals — and every cell in your body — to function
properly. Calcium and several trace minerals like zinc, manganese, selenium, and
iodine provide calming effects in the body. These minerals can help to relieve the
stress that comes with and causes adrenal fatigue, which will ultimately lessen
your cortisol output.
A strong nutrient foundation also supports the endocrine system overall. There is
great synergism between the different organs of the endocrine system (including
the adrenal glands), where each organ and its secretions interact with the others
to upregulate and downregulate activity to keep us in balance. But as hormonal levels
become deficient or excessive, the natural response of our cells is to compensate
by increasing or decreasing their receptors for those molecules. To do all this
optimally, they need nutritional support!
Small things, dramatic differences
Your adrenal glands are tiny in comparison to many other organs. They are roughly
the size of a walnut, yet they have enormous responsibilities in your body. When
they are functioning at their peak, these small glands can help you feel energized
when you need to be and relaxed when it is time for rest. They contribute to the
production of estrogen, testosterone, progesterone and so much more. But life’s
demands can slowly drain the balancing power of the adrenal glands. Even the healthiest
person’s adrenals, though evolutionarily equipped to handle periods of stress,
become fatigued under chronic, unrelenting stress.
You have the power to lessen the burden on your adrenals — and your whole
body. It doesn’t take much. The small choices you make in regards to your
nutrition and eating patterns will make a difference. Here’s my advice to
you: support your foundation with a high quality nutritional supplement and eat
good food in harmony with your body’s natural daily rhythms. Soon you’ll
find the energy you thought you lost — and it’ll be here to stay!
Our Personal Program is a great place to start
The Personal Program promotes natural adrenal balance with nutritional supplements,
our exclusive adrenal support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
We’re always happy to welcome new patients to our medical clinic in Yarmouth,
Maine, for those who can make the trip. Click
here for information about making an appointment.
Related to this article:
References & further reading on
eating for adrenal health
Original Publication Date: 05/12/2008
Last Modified:
02/16/2010
Principal Author: Marcelle Pick, OB/GYN NP