The Modern Lifestyle - A Recipe for Adrenal Fatigue? | Chris Kresser

The Modern Lifestyle: A Recipe for Adrenal Fatigue?

by Kelsey Kinney, RD

Published 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

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!

135 Comments

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  1. My husband is a Type A–naturally high cortisol, so I do all the things you mention, plus supplement him with L-theanine. I can’t clear the roads of idiot drivers for him, and can’t magically make his boss grow a brain (or a pair), so he has a bottle of L-theanine in his desk for when these (and other) things cause him stress.

    He has a congenital heart issue, so he can’t take the other “calming” supplements like Relora, ginseng, or rhodiola.

  2. I was diagnosed with the beginning of total adrenal failure about a year ago. I found it inadvertently while pursuing alternative treatment to spinal fusion surgery for degenerative disc disease (DDD). I went to a functional nutritionist to see if she could help me find out why my discs were deteriorating when I had taken care to eat whole, organic foods and exercised five days a week to stay fit for the last thirty years. I chose her because she was also a chiropractor and who better to know the back? I filled out an extensive form of my health history and any issues I presently have. My only other health issue was Hashimoto’s (autoimmune hypothyroid). The first thing she did was to check my adrenals because she said my symptoms and thyroid issue were red flags to adrenal issues. Sure enough I was in the beginning of complete failure. She drew blood to test for any foods that were causing an immune response to avoid (to help keep the adrenals calm) and then prescribed some adrenal support tinctures and vitamins. I followed the very narrow diet faithfully for a year. While I had already chose to quit gluten it showed up as an adrenal stimulator as did some very surprising foods. She stated that many of the foods I ate a lot like bananas, lettuces, olives, etc . . . would most likely show up and once my adrenal was up to par I could add them each back into my diet one by one to watch to see if they still bothered me in any way. I have since added all back in except the gluten foods and sugar because after being off of them I did feel better. I will be tested for gluten issues just to make sure it is necessary. I am using pure stevia, LO Han, maple syrup, dates, coconut sugar and honey when I make recipes that call for sugar and only then and sparingly. We just checked my adrenal levels and they have come up a little so it is working and I will continue this protocol. It made sense that the adrenal failure could have caused the disc degeneration because cortisol, an adrenal hormone has a lot to do with cartilage formation which the spinal discs are made of. I have always had stress in my life so it could have been going on for quite a while. I have always been told I was great under pressure, but even though I showed no signs outwardly, my body paid for my ability to internalize the stress. So just because you do not feel stressed, you could be laughing for it physically when you know you are under it. I learned the hard way. I am hoping that if I can get my adrenals up to par that just maybe my body can once again build the cartilage in my body and strengthen the spinal discs walls to where the degeneration is resolved or at least stopped in its tracks. Conventional docs say there is no cure and it will not happen, but has anyone one of them tried this? No. I will not go down without fighting this DDD malfunction even if it is looked at as incurable according to conventional medicine. Let’s face it, all they have offered me was addictive narcotics for the pain and surgery. From my research, more often than not, both offer more complications than cures and neither are are guaranteed to help with the nerve pain. I took the pain pills for three months and I that short time they tore my stomach up with three gaping holes and an inflammed lining so I totally quit them a year ago. Conventional medicine only treats the symptoms (inadequately) instead of finding and resolving the cause. I have chose to suffer a little longer from the pain (has caused shingles as of late, ugh), give this protocol a try and avoid addiction and a possible botched up surgery. I have minimalized the pain with Rick Simpson’s oil when I over indulge in physical activity (anything except lying in bed propped up in a zero gravity position) that intensifies the pain and hope. My advice from my experience is to not ignore any amount of stress, even if you seem to handle it well. Actively deal with unavoidable stress immediately and do what you can to minimalized stress in your life.

    • Sorry, auto correct changed the phrase “you should be looking” to “you could be laughing” making that sentence kind of out there.

    • I truly appreciate you sharing your life experience and about adrenal fatigue. It opened my eyes up, and I will heed your advice. I hope very much this resolves for you.

    • Carol, your story resonates with my own so I’m desperate to find guided help. Please tell us the name of the blood test you had done to determine which foods your body doesn’t like. Lettuce? It seems so innocent, who knew? (I understand that’s not applicable to everybody, but to you specifically).

      I’ve had several food sensitivity tests done only to contradict one another. In the end, it’s really just leaky gut from what I understand. To heal myself feels daunting – its already been such a long journey yet never improving. However, your story gives me a little more hope. Thank you.

  3. I’m interested in alarm clocks that wake you calmly. But I’m alarmed at the suggestion of sleeping with your smartphone due to all of the negative health impacts of EMFs. (The entire latest issue of Wise Traditions outlined how harmful they are) Is there another kind of alarm clock that doesn’t rely on wireless technology?

    • I use a wake up light when I need an alarm. Mostly though I don’t even need to wake up to an alarm.

    • You can also put your phone on airplane mode when you go to bed, the alarm will still go off but no wifi – significantly reducing the EMF exposure.

      Further, there are EMF protection devices you can buy, inexpensively, to re-harmonize the effects of the EMF.

      Keep reading WT, great info there.

    • I agree with Lee about the EMF concerns of smart phones AND Bluetooth devices like the Jawbone. I personally found that moving my phone into another room when i sleep dramatically improved my sleep. However, I’m always still posed with a problem when I need to wake up by a certain time. Any suggestions to devices with low EMF?

      • Try the EMF protection devices. They are not so cost prohibitive and will re-harmonize the EMF.
        I am not selling or making commission from them but there are different brands out there, just do your research. I have not tried any yet but know people who have and like them, for example the safe space ones.

  4. I love the 6 simple points you recommend for adrenal balance. I tried a lot carb diet for so long, thinking I should not “feed the bugs” or spike my sugar. Adding carbs back into my life has raised my body temperature, fixed my hypothyroid and estrogen dominance, and helped me FIGHT Lyme Disease. Last year I would be too afraid to up my carbs even though my low carb diet did nothing for my POTS, sepsis, fevers, brain fog and the above conditions. This year I am doing pull-ups and rock climbing with no adrenal repercussions. I’m giddy and grateful for my new-found giddyness.

    Question: If you are doing high intensity exercise every few days, are sugar spikes still something to be concerned about? I eat a lot of protein, and a healthy dose of yolks and coconut oil, but I also eat heaping teaspoons of manuka honey in between meals. I am curious to see my BG is when I do this, but I feel like insulin resistance is not something to worry about while I’m going this hard with exercise every 2-3 days.

    • You likely don’t need to worry about the BG spikes with lots of exercise, though if you’re worried or have a history of BG issues, you can use a home glucose monitor to make sure you’re doing ok in that regard.

      Good for you for upping your carbs!

  5. This article was frustrating. Suppose you are already doing all the recommended things and still struggling with AF? The information was so basic, nothing new. Was the article an infomercial for your upcoming program? You did talk about some lifestyle changes, but nothing about tests, supplements, traatments, etc.

  6. The ‘normal’ routine described makes me stop and ponder… “What kind of an existence have we created — and how did it happen?”

  7. I have none of the symptoms of adrenal fatigue as listed but a saliva test came back showing cortisol/DHEA substantially lower than the normal range on waking but catching up steadily by 10pm. My life is delightfully low stress – a healthy 67 year old whose only problem appears to be mildly high cholesterol. I eat a moderate carb diet, no sugar, no processed food. Should I be worried? Should I take any action.

    • Hi Lisa,

      Having low cortisol and DHEA isn’t good, so I would definitely suggest taking some action to correct it. Check out the free 28-page ebook I’ve linked to for some tips there!

  8. I have Insomnia,Overactiv Immune system which created arthritis
    and memory loss and constipation.
    I would like to know what cause an overactive immune system?
    Autoimmune disease which is the cause of its own destruction
    as the body start producing antibodies to its own tissues. that caused an arthritis and memory disturbance.

    • Magnesium is excellent for constipation! Take 300-500mg at bedtime as it a natural muscle relaxer. Eliminate dairy and gluten for arthritis. Take Curcumin for inflamation, and fish oil. Fresh ginger tea every morning for pain.

    • Also trifala is excellent for constipation. Flaxseed stirred into juice and coconut oil keeps your colon active

  9. Loved the article. Whats your take on eating more fish, krill oil or algae dha/epa oil supplements when one have adrenal fatigue?

    Minimize PUFA or eat more? Can they help quicker restore balance, as complementary to the great method you posted of stabilizing bloodsugar? Kind regards from Sweden

    /Marco

    • Hi Marco – I’m a fan of eating fish to get your omega-3s and personally I don’t worry all that much about getting a little bit of extra PUFA to do so.

      I get a little worried about fish oil supplements, though, given there’s some concern over oxidized/rancid supplements out there.

      • Ah, i share that concern to about supplements.
        Thanks a bunch for the answer and again – great article 🙂

  10. It’s actually rather exciting to see a good article recommending that normal people should use orange glasses (or preferably goggles!) for avoiding evening blue light. This so-called dark therapy, in addition to bright light exposure at the time of one’s natural awakening, can be helpful routines for many of us with chronic circadian rhythm disorders (CRDs). As the public becomes more educated about normal sleep, I think it will be easier to explain and gain understanding for our CRDs. Thank you!

  11. Although my cortisol levels are low, I was puzzled that I didn’t fit the usual profile for adrenal fatigue, i.e. high blood pressure instead of low. It was only when I read about “sympathetic dominance” that I recognised my set of symptoms. Does anyone relate to this?

  12. Getting divorced, not by choice though – narcissistic husband chose to leave his wife and 3 young boys for some young chick at the office. The right thing would have been him going in therapy, but that is not how life works with narcissistic people. However wrong divorce is, in the light of what kind of person he is, I am better off without him. Lots of emotional stress going on for too many years. Boys are hurting and struggling.
    Pace myself. Working towards paleo with a healthy amount of carbs, didn’t eat bread for years already, also got iron deficiency without anemia, am going to have Dr’s find out why my iron vanishes. Need daily naps which is discouraging.
    I crochet, works as therapy (as do quilting and cross stitching). In work outs focused more on building muscle than high intensity.

  13. I can’t understand this part. It seems like dropping you blood sugar makes that your body burns fat, why is bad?

    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.

  14. I was stage 2. I got good nutritional advice had my Metabolic Typing done for optimum food choices and the correct supplements from a recommended registered site rather than over the counter. Take time to look after you, everyone and everything else will wait and you will be able to give a quality you. ( this I found hard to do but now I’m glad I did )

  15. I hit the wall with adrenal burnout and 10 years later, despite quitting work, moving to the country, doing all the right things nutritionally, I just didn’t get better. Then I found out I had pyroluria – a severe deficiency of zinc & B6 – and according to all I’ve read it’s surprisingly common. Worth checking out as the solution is vitamin and mineral supplements.

    • Hi Lyndall,
      I have pyroluria also, and just done testing for andrenal fatigue and have low levels of cortisol in the morning, and higher than normal levels at night time. I’ve been on B vitamins and zinc supplements for about 2 years now and overall feel better, but still really low energy and weight issues from the adrenal fatigue. Did your adrenal issues get better after the supplements for pyroluria? thanks

  16. Hi Kelsey, I am a HHP MT, and work to much.
    I believe in acupuncture. So every couple of months i get a treatment to regain my balance and strengthen my adrenals.

  17. “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.”

    What about the positive effects of intermittent fasting on cognitive function?

    • David has the right idea here – for those with adrenal fatigue, intermittent fasting is not a good idea. Sometimes people choose to go back to it after healing, but I usually recommend staying away from it as someone with adrenal fatigue may be more likely to get it again in the future if they go back to the habits that got them there.

  18. Hello.

    I have stage III adrenal fatigue and have been on Hydrocortisone for more than a year. I’ve started to wonder if I would ever get well and get off those drugs…

    • Hi Quinny,

      Though I think supplements and sometimes pharmaceuticals like hydrocortisone can really help, they’re not the only answer to healing. In fact, if you’re not following a adrenal-healing diet and lifestyle even with hydrocortisone it’s not likely you’ll fully recover. Did you check out the free ebook I linked to? It will give you an in-depth overview of what to do to heal. Hope it helps!

  19. I was diagnosed with adrenal fatigue 4 months ago and I’m still on my healing journey. I have incorporated most of what you suggest, regular meals which always incorporate protein, yoga (I reluctantly quit my intense gym workouts, knowing they were not helping me recover), a few temporary nutritional supports like vitamin c, magnesium and b vitamins but the thing that has helped the most is finally addressing the emotional factors that so often underpin adrenal fatigue. Unhealthy beliefs, living life not true to your values because you are stuck in a rut, perpetual negative thinking patterns. I personally believe this is key, and if you can address this then stress should no longer be an enemy in the future.

  20. If a person has adrenal fatigue, I assume it is best to avoid foods with caffeine such as coffee. But how about decaf coffee?

    • I recommend staying away from caffeine as you recover, as well as alcohol (at least for the most part – a drink here or there is probably okay).

      Decaf coffee still contains some caffeine, so to be safe I just say stay away from it all. It’s good to give yourself a caffeine detox once in a while anyway!