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Adrenal Fatigue: Beyond the Basics

Beyond the Basics of Adrenal Fatigue


In this week’s installment, we will recap what we learned from last month’s lecture by Dr. Thomas Moraczewski, in regards to adrenal fatigue.

What is Adrenal Fatigue?

The adrenal glands are two tiny glands sitting near your kidneys. They are responsible for the release of multiple hormones, including adrenaline, noradrenaline,cortisol, DHEA, Pregnenolone and Aldosterone. These hormones are responsible for a slew of functions in your body, including  blood pressure control, your stress response, inflammation and your energy levels. That’s a lot of pressure for two little glands!

When you are under acute stress, your body will go into “fight or flight” mode. For example, if you were chased by a ferocious lion, your cortisol and epinephrine will rise. In turn,your heart rate will rise, your blood sugar will rise in response to the threat, and you will have energy to run from your predator. In this day and age, we are not faced with acute stresses that dissipate quickly. In our society, our work, daily life, traffic, bosses, etc, provide chronic stress. Instead of having bursts of activity from your adrenal hormones that are followed by periods of recovery, we have a constant elevation of these hormones. This will eventually tire the glands out,which can cause adrenal fatigue or adrenal burnout.

What are the symptoms?

Adrenal fatigue can manifest with various symptoms, including, but not limited to the following:

  • Feeling tired for no reason
  • Having trouble awakening in the morning, even when you go to bed at a reasonable hour.
  • Feeling rundown or overwhelmed.
  • Difficulty bouncing back from stress or illness
  • Craving salty and sweet snacks
  • Feeling more awake, alert and energetic after 6 PM than you do all day.

How do we test for Adrenal Fatigue?

The diagram below depicts the cascade of some of the most important hormones in your body, including cortisol.


In adrenal fatigue, a phenomenon called “cortisol steal” may occur. Take note of the pathway. As you can see, all of these hormones originate from cholesterol, which converts into pregnenolone. If your body senses constant stress, your hormones will shift to produce more cortisol. The pathways of the sex hormones and the hormones for blood pressure (aldosterone) will be ignored. This contributes to the symptoms of low energy and low libido of adrenal fatigue.

In early cases of adrenal fatigue, your body may be compensating , and your cortisol levels may appear normal. However, testing of pregnenolone and DHEA may clue your clinician in regarding what is really going on.

In addition to blood tests, we use salivary testing in our office to determine cortisol levels throughout the day. This gives us an accurate picture of your cortisol , instead of merely a snap shot in the morning.

Why have my other doctors not tested for it already?

In conventional medicine, adrenal fatigue is a diagnosis that is not readily recognized at this time. Most conventional practitioners have been trained to recognize the extremes of the spectrum . In these extreme  cases, conventional blood tests will reveal the answer. However, there are many people who fall in the middle of the spectrum disorder and experience the symptoms listed above. These people benefit from investigation of salivary hormones, and the introduction of certain therapies.

What are the medicines , herbal or alternative therapies that can help me?

If the diagnosis of adrenal dysfunction is confirmed, the basic approach that we take in our office is to approach lifestyle therapies, nutrient repletion, hormonal support and supplementation with calming and adaptogenic herbs.

Prior to initiating any therapy, it is best to consult a clinician who can guide you to a therapy/therapies that will be most efficacious for you.

With our patients, we always like to start with lifestyle modifications. For example,  we would closely examine your work situation, and adapt techniques such as deep breathing, meditation, massage and yoga. Sleep is an essential part of adrenal health, and should not be overlooked.

In terms of supplements, essential oils, vitamin C and B vitamins have also been shown to support adrenal health. Taken before bed, magnesium can be relaxing and calming. While proven beneficial, Magnesium levels should always be checked and monitored by a clinician.

Adaptogenic herbs are plant based products that work on the brain-adrenal stress response. These herbs have the ability to lower cortisol levels when they are high, and increase cortisol when levels are low. Some adaptogens that have shown clinical efficacy are Ashwaganda, Holy Basil, Relora, L-Theanine and Magnolia.

Calming herbs and teas such as passionflower, hops, valerian, chamomile and lemon balm have also been helpful to some of our patients. While all of these therapies may be helpful, it is best to consult with a practitioner who can guide you in which therapies may provide the most benefit to you, given your situation and current state of health.

Adrenal dysfunction may be contributing to your systems of fatigue and burnout. We hope that this post has gone ‘beyond the basics’ and has given you some insight on what you can do to optimize your health!



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