The Modern Lifestyle: A Recipe for Adrenal Fatigue?

The Modern Lifestyle: A Recipe for Adrenal Fatigue?

by Chris Kresser

Last updated on

Is daily stress in your life leading to or causing adrenal fatigue? Find out what the symptoms are and how you can keep yourself healthy in the modern world.

adrenal fatigue
Are the stresses of modern life giving way to adrenal fatigue? Hemera Technologies/AbleStock.com/Thinkstock

This is a guest post written by staff nutritionist Kelsey Marksteiner, RD. Click here to read her blog or join her newsletter!

Modern life is full of stress. From financial problems to traffic to waking up before we’re fully rested, we are surrounded by stressors all day long.

What Is Adrenal Fatigue?

When the body is exposed to stress, the hypothalamic-pituitary-adrenal axis (or HPA axis for short) is activated, and a cascade of hormonal changes occur to eventually cause the release of cortisol (our stress hormone) from the adrenal gland. Normally, when a stressor goes away, negative feedback cycles serve to turn off the HPA axis and reduce the release of cortisol. In the modern world, however, many of us are constantly activating our HPA axis.

When we’re exposed to chronic stressors over a long period of time, our adrenals pump out more and more cortisol as we become more and more resistant to its effects. The negative feedback cycles that normally keep things in check get turned off, and our health suffers as a result. Eventually, the HPA axis can’t keep up with the demand for cortisol, and cortisol levels become low. (1) This dysregulation of the HPA axis is what we refer to as “adrenal fatigue syndrome”. “Adrenal Fatigue” is a syndrome, not a disease, which means it is a collection of symptoms. Symptoms of adrenal fatigue syndrome are numerous and include:

  • Waking up unrested
  • Decrease ability to handle stress
  • Brain fog or decreased cognitive ability
  • Dizziness when standing from sitting or lying down
  • Low sex drive
  • Increased severity of allergic responses
  • Low blood pressure
  • Low blood sugar
  • Weakness, and more…

With stress all around us, are we doomed to develop adrenal fatigue syndrome?

A Day in the Life

Let’s break down the most common stressors leading to adrenal fatigue by jumping into the shoes of a modern worker:

You startle in bed when you hear the distinct buzz of the alarm clock blaring in your ears. You’re startled, already activating the HPA axis and increasing your cortisol. You haven’t slept until you’re ready to wake up, and it’s not as if you were a few minutes off from the eight hour mark. Sadly, you fall into the third of Americans who get less than 6 hours of sleep a night. (2) This lack of sleep has serious consequences for you, including mood and cognitive issues as well as an increased risk of metabolic problems. (3, 4) Sleep deprivation activates the stress response and causes an increase in cortisol levels (5), priming you for adrenal fatigue.

You rush through getting ready for work, stuffing breakfast in your mouth as you gather up everything you need to go. Sit down for breakfast? Who’s got time for that? Perhaps you’ve chosen a standard American high carbohydrate, high glycemic load breakfast like cereal with skim milk, which shoots your blood sugar up high, only to drop it low in the coming hours. Seriously low blood sugar can be life-threatening, so it’s no wonder your body views it as a stressor. When blood sugar drops, the adrenals release cortisol and epinephrine, sending a signal to the body that it needs to get glucose into the bloodstream as soon as possible. When this happens, the body responds by breaking down glycogen (the stored form of glucose) as well as working to create new glucose from protein and fat through a process called gluconeogenesis. In short, every time blood sugar drops, it’s an emergency signal to the body and the HPA axis is activated.

But let’s say you’re health-conscious – perhaps you’re into the Paleo diet and have chosen to eat low-carb. You rush through breakfast to make it to the gym before work so you can fit in a high intensity exercise routine. This might sound like a healthy lifestyle, but don’t think you’re off the hook quite yet. A consistent low carbohydrate diet coupled with intense, anaerobic exercise forces the body to rely on the same stress-fueled process of creating glucose that occurs with the low blood sugar scenario I discussed above. Whether you’re eating a processed, high-carb diet or a low-carb diet in combination with intense exercise, your adrenals are taking a hit.

You get in your car, only to get stuck in traffic. Getting cut off left and right, you curse the other drivers you share the road with, activating the HPA axis with each encounter. Finally, you arrive at work. Your boss passive aggressively signals that he’s unhappy with your tardiness, putting you in a sour mood, and you finally sit at your desk. Work is stressful – everyone seems to have a problem and you’re supposed to have the solution. It makes you wonder if you’re paid enough to do your job, which gets you thinking about how life would be so much easier if you just made more. You’re certainly not alone here: money and work are the two most common things causing significant emotional stress for Americans. (6) This is the kind of stress that truly separates us from our ancestors. Whereas their stressors were acute (i.e. being chased by an animal), ours are chronic emotional issues that never truly leave us. It’s hard to imagine our ancestors worrying about the economy, isn’t it? It’s these stressors that take the biggest toll on our adrenal health by consistently activating the HPA axis.

By the time you get home from a long day at work, all you want to do is relax. You make dinner and sit down to eat while you watch some TV. For the rest of the night, you’re glued to the TV, your phone, or the computer until it’s time to sleep. Even if you’re in bed on time, you’re likely in bed surfing the internet on your phone or watching more TV – with so many options of things to do, it’s hard to convince yourself to actually sleep. The blue lights emanating from your screens reduce the production of melatonin (the sleep hormone). (7) This can lead to insomnia or disrupted sleep, causing you to get less sleep than you need. Perhaps you find yourself turning off all the devices and trying to fall asleep, only to find yourself worrying about upcoming deadlines. All of these issues lead you to get less sleep than you need and you wake up unrested the next morning to start the cycle all over again.

Preventing and Healing from Adrenal Fatigue in the Modern World

The modern lifestyle stacks the odds against us and can lead to adrenal fatigue, but that doesn’t mean we’re doomed. In fact, there’s a lot we can do to keep ourselves healthy. Here are my top tips for keeping your adrenals in good shape, even in the modern world.

  • Leave yourself time to sleep for 8 hours per night – that means you’re in bed, ready to go to sleep by 10 if you need to be awake at 6. If possible, use an alarm clock that wakes you up gently by monitoring your sleep cycles (I like activity bracelets that wakes you up by vibrating on your wrist like the Jawbone Up24 or the app Sleep Cycle for this purpose).
  • Limit your exposure to blue light by using orange glasses or installing apps like F.lux on your computer. Chris has an excellent article about this topic if you want to learn more about blue light.
  • Eat on a regular basis and don’t go too long without meals – if you’re worried about your stress level or think you might already have adrenal fatigue, I’d highly caution you against skipping breakfast (or any meal, for that matter) regularly. Getting a high protein breakfast in the morning stabilizes your blood sugar throughout the day, which in turn helps to keep your HPA axis functioning appropriately.
  • Don’t skimp on healthy carbohydrates like fruit and starchy tubers if you’re worried about your adrenal health, especially if you’re also engaging in high intensity exercise. A moderate carbohydrate diet is best for those with high stress levels or recovering from adrenal fatigue.
  • When you do eat carbohydrates, combine them with protein and fat to slow absorption and stabilize your blood sugar.
  • Start a mind-body activity practice like meditation or yoga to reduce mental and emotional stress. The benefits of implementing a stress management practice grow over time, so the sooner you start, the better!

If you’re worried you might already have adrenal fatigue and want to learn more about how to recover, Laura Schoenfeld and I are launching our new program Paleo Rehab: Adrenal Fatigue in late April. In it, we cover the diet, supplements, and lifestyle changes you need to make in order to heal. Get on the mailing list and receive our free 28-page eBook Overcoming Adrenal Fatigue.

Now I want to hear from you: what are you doing to prevent or heal from adrenal fatigue?

Kelsey MarksteinerThis is a guest post written by Kelsey Marksteiner, RD. Kelsey is a Registered Dietitian with a Bachelors degree in Nutrition from NYU and a Master’s in Human Nutrition and Functional Medicine. She works in private practice and recommends individualized dietary therapy focusing on biologically appropriate diet principles to aid her clients in losing weight, gaining energy, and pursuing continued health. She is a firm believer that everyone is different, and she tailors her plan for each and every individual. Through her work, she aims to meld the dietary wisdom of traditional cultures with the latest science in integrative and functional medicine to create plans for her clients that work in the modern world. You can learn more about Kelsey on her staff bio page, or by visiting her private practice website. Join her newsletter here!

135 Comments

Join the conversation

  1. I have been under stress for 9 months. I am dizzy, memory recall probs, way tired in the AM, eyes blurry, loosing weight, mild headaches, feeling general malaise. I haven’t sought help. I have the classic symptoms of adrenal fatigue. Im looking for some guidance. Help please.
    I have read quite a bit and understand the physiology which is rather complicated, but I’m looking to return to happy and some normalcy. Thanks

  2. I do not see anything related to high dhea/low cortisol. Do you know anything about this? I got my saliva test results back and they were:

    DHEA: 13.4 (Ref Range 0.7 – 9.4)
    Cortisol (Morning): 3 (Ref Range <15)
    Cortisol (Midday): 4 (RR<8)
    Cortisol (Evening): 5 (RR<5)
    Cortisol (Midnight): <3 (RR<3)

    In addition to that for the first time ever, I have raised fasting glucose, still within range but barely. I have gained weight too.

    Do you know if I have adrenal fatigue based on the above values? If so, what stage am I in?

    I just dont get it because everyone talks about DHEA supplementation, but my DHEA is high.

    Ill be consulting my doctor soon just wanted your opinion. thankss!!

    • Hi Ken, I’m not a doctor of medicine, but I had a terrible adrenal crash last year at the end of April 2014, due to Lyme.

      I can tell you that adrenal insufficiency is basically a flat cortisol level that is low throughout the day. This is a more Se ere form of adrenal fatigue. My blood cortisol levels morning , afternoon were just 1. They should be 20 in the morning and around 10 to 11 in afternoon. Blood cortisol measures both free and bound cortisol, and providing globulin levels are normal, and mine were, it is a very accurate assessment of one’s cortisol. Saliva is accurate but measures free cortisol, which is fine. Adrenal fatigue is any derangement in the normal cortisol rhythm:high in morning and then sloping down throughout the day. The ranges are broad, as you can see. Your morning cortisol looks to be low relative to the ranges. You don’t have adrenal insufficiency, but your morning cortisol looks to low. Dhea has an opposing action with cortisol, so you might be in stage 2 of fatigue where the adrenals are still able to generate sufficient hormones, but are slowly declining. Your cortisol rhythm during the day is deranged. If you could find a functional dr, he should be able to help you. Conventional medicine still adheres to the very broad ranges indicated in lab reports, as the norm. Cortisol of 3 in the morning is nor sufficient. You should be generating more cortisol than that during the night. If you are not sleeping that well this can contribute greatly to a low morning cortisol, with high adrenaline and noradrenaline levels.

    • I think Chris mentioned in an article or podcast that DHEA lowers cortisol, and pregnenolone raises it. Don’t take my word for it, but you might want to do a search. Or it might have been Robb Wolf. In any case, DHEA is NOT for every adrenal patient.

      • By the way, my DHEA is low, and my cortisol is wonky but overall high. I supplement DHEA, which seems to help. I had an adrenal crisis recently soon after cutting my DHEA dose in half.

  3. Did you ever launch this as stated it would be in the article above?

    ….”receive our free 28-page eBook Overcoming Adrenal Fatigue”.

    supposedly coming in spring 2015

  4. It has been suggested that a mildly ketotic state is natural by virtue of the fact our ancestors would not have had a steady supply of carbohydrates. Therefore how exactly does a low carb diet ‘stress’ the adrenals assuming excessive exercise is not pursued? Carbohydrates create instability in the bloodstream through their effect on blood glucose levels, in turn requiring the release of insulin which will then cause an overcorrection (since negative feedback is never perfect) and a state of hypoglycaemia at which point the adrenals must re-correct. A system running on ketones provides a constant supply of energy, without swinging blood glucose levels.

    • Yes Tom I agree – nutritional ketosis is the most healthy state not likely to cause adrenal fatigue – eating starchy root veggies is likely to cause far more issues! Manage stress through mindfulness, exercise and most importantly by seeding and nurturing your gut biome.

      • Karen,
        Are you convinced that introducing a probiotic into your diet is justified by the evidence? Swallowing a probiotic capsule seems ostensibly unlikely to do much when you consider the trillions of bacteria in your gut. Like putting some bubble bath in a lake?!

    • Our ancestors probably did not get adrenal fatigue, because the nature of stress is very different today than it was a thousands of years ago. Also our guts were way healthier. (This is why Dr. Wilson’s book is called Adrenal Fatigue: The 21st Century Stress Syndrome). Chris recommends a moderate carb diet to people with adrenal fatigue but warns not to over-consume carbohydrates (for the very reasons you mention).

  5. Can adrenal fatigue cause one to lose one’s taste buds? I haven’t been able to taste anything but salt for about 15 days now. 🙁 I don’t crave salt or any foods….just can’t taste them. Rather disheartening….

    • Amy,
      Being low in zinc can cause you to loose your taste buds , as well as many other things I’m sure .