Adrenal Fatigue

Your adrenal glands play a central role in your endocrine system when it comes to regulating and reacting to your body’s stress levels. When they are functioning properly, you are able to effectively accommodate and react to the day-to-day stresses that you encounter.
Adrenal fatigue is the common name for a set of symptoms that result from the adrenal glands being worked to exhaustion. For the majority of cases, adrenal fatigue is secondary to some other underlying health issue such as chronic, hidden inflammation.

“Adrenal fatigue is the result of a stress response that can take years to manifest.”

Your adrenal glands are each no bigger than a walnut and weigh less than a grape, yet are responsible for one of the most important functions in your body: managing your stress.

When your adrenal glands are overtaxed, a condition known as adrenal fatigue or adrenal exhaustion sets in, which in turn can set a cascade of disease processes into motion. One tell-tale sign of adrenal burnout is feeling chronically fatigued.

It’s estimated that up to 80% of adults experience adrenal fatigue during their lifetime, yet it remains one of the most under-diagnosed illnesses in the United States.

Unfortunately, while many conventional health practitioners have started testing adrenal function, many are still unaware of the protocols for solving adrenal dysfunction.

If you’re suspecting that you have adrenal fatigue, ask yourself if you suffer from these adrenal fatigue symptoms:
  • get tired for no reason
  • have trouble getting up in the morning
  • need caffeine or energy drinks to get going
  • crave either salty or sweet snacks
  • trouble falling asleep or staying asleep
  • chronic allergies
  • poor memory
  • poor concentration, brain fog
  • depression
  • menstrual cycle irregularities
  • chronic pain
  • slow healing from injuries
  • inability to handle stress
If you answered yes to any of these questions, then adrenal fatigue is likely a part of your health condition.

How to Test Your Adrenal Function

Traditionally you would see an endocrinologist or possibly an internist who would evaluate your adrenal glands. Unfortunately, they tend to primarily test for specific diseases like Addison’s or Cushing’s, which are relatively rare.

In the conventional medical context, when they think about the adrenal glands, they really only think about extreme medical conditions that are not going to be what most suffer from. They do a conventional medical test to determine whether or not you have one of these rare endocrine disorders.

In the conventional medical world, they look for disease processes, but we look for functional problems using special lab tests like the functional adrenal stress profile.

The Carroll Institute Method calls for testing your adrenal function by taking four saliva samples over the course of a day. This maps out your circadian rhythm, showing how your cortisol levels rise and fall throughout your day. 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.

Four Causes of Adrenal Dysfunction

There are four main causes of adrenal fatigue and dysfunction:

1. Emotional stress: Typically related to grief or loss

2. Poor diet: Eating too many carbs can disrupt cortisol and a group of corticosteroids (a blood pressure-stabilizing hormone). The Standard American Diet (SAD) is a perfect recipe for destroying your adrenal glands.

One of the most important things that cortisol does is regulate secretory IgA in your gut. What this means is that the immune response in your gut is controlled by cortisol. Hence, if you’re stressed, the immune response in your gut suffers, and the gut tissue becomes damaged. This then leads to good bacteria giving way to bad bacteria, causing immune dysregulation that is centered in and around your gut.

3. Chronic inflammation in your body: Inflammation is the hallmark of virtually every disease, from diabetes to cancer, and when chronic, it stresses your system, including your adrenals.

4. Hypothyroid: Thyroid function is intricately intertwined with adrenal function. Thyroid disease can only be properly diagnosed with a thorough Thyroid Blood Panel. A complete panel is, unfortunately, rarely performed.

Below are areas of the body that are negatively impacted by adrenal exhaustion and the chronic stress response that causes it:

Energy Production

Abnormal adrenal function can alter the ability of cells to produce energy for the activities of daily life. People who have a hard time rising in the morning, or who suffer from low energy throughout the day, often have abnormal adrenal rhythms, adrenal fatigue, and poor blood sugar regulation.

Muscle and Joint Function

Abnormal adrenal rhythms are known to compromise tissue healing. Reduced tissue repair and increased tissue breakdown can lead to muscle and joint wasting with chronic pain.

Bone Health

The adrenal rhythm determines how well we build bone. If the night and morning cortisol levels are elevated, our bones do not rebuild well, and we are more prone to osteoporosis. In postmenopausal women, the effect of stress worsens due to female hormone imbalances.

Immune Health

Short- and long-term stress is known to suppress the immune response in the lungs, throat, urinary tract and intestines.

Sleep Quality

In sleep-deprived individuals cortisol levels are elevated. Evening cortisol level is increased in patients with insomnia, affecting the first part of the nocturnal sleep period, increasing risk for depression. Chronic lack of REM sleep can reduce a person’s mental vitality, vigor, and induce depression.


Couples with high levels of stress markers are less likely to succeed in conceiving. Stress alters the brain signals that trigger the ovaries to release eggs each month, so women under non-stop stress ovulate fewer eggs than less stressed women. Stress can also affect testosterone level and sperm production in men. Helping couples to de-stress while trying to conceive can impact their success rate.

Skin Regeneration

Human skin regenerates mostly at night. With higher night cortisol values, less skin regeneration takes place. Thus normal cortisol rhythm is essential for optimal skin health.

Thyroid Function

The level of cortisol at the cellular level controls thyroid hormone production. Often, hypothyroid symptoms such as fatigue and low body temperature are due to stress or adrenal fatigue. Chronic stress will convert thyroid hormone to its inactive form (reverse T3) and shut down the production of TSH.

Gluten Sensitivity and Stress Response

Approximately 12-18% of the U.S. population suffers from a genetic intolerance to grains (wheat, rye or barley) contained in cereals, breads, and pasta. The gut becomes inflamed within 30 minutes after consuming grains, and this can lead to an adrenal stress response, increased cortisol, and reduced DHEA.


Sustained stress adversely affects brain function and memory processing. Too much cortisol interferes with the functioning chemicals the brain uses for its cellular intercommunication, as well as decreases the function of the hippocampus, which is the part of your brain that forms memories.

Chronic Fatigue Syndrome (CFS)

A common adrenal fatigue issue in CFS is impaired corticotrophin release.

As a result, low cortisol and eventual adrenal atrophy may be observed. Simultaneous use of several therapies can help to improve the debilitating effects of CFS.

Glycemic Dysregulation

Chronic low blood sugars can impair normal adrenal function by repetitive over-stimulation of cortisol production. Recurring exposure to high cortisol will impair insulin activity, and invariably lead to insulin resistance and diabetes.


Several recent publications report a hyperactive HPA axis in depressed patients. Elevated midnight salivary cortisol is now considered one of the best tests in diagnosing endogenous depression. Other anomalies in cortisol rhythm usually accompany the midnight elevation. On the other hand, cortisol elevations and rhythm disruptions throughout the day are typical of attention deficit disorders (ADD).

“Functional Medicine is an innovative approach to medical care. It uses the latest medical research to develop personalized care for each patient based on his or her unique environment, lifestyle, and genes. The result is a dynamic, effective way to address chronic disease. And it really works.”

Catherine Guthrie,Experience Life, December 2013, The Institute for Functional Medicine

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