What is Adrenal Fatigue?

What is Adrenal Fatigue?

Adrenal fatigue is one of those terms that natural health practitioners have discussed for decades, but conventional medicine is only recently beginning to acknowledge.

You won't find "adrenal fatigue" in medical textbooks. It's not recognized as a disease. But the symptoms are real, the mechanism is understood, and millions of people are suffering from it right now.

Adrenal fatigue describes a state where your adrenal glands can't keep up with the demands placed on them. They're not pathologically diseased (Addison's disease). They're just exhausted—hypofunction rather than complete failure.

This matters because your adrenal glands regulate stress response, inflammation, blood sugar, immune function, energy production, and more. When they're depleted, everything breaks down.

Here's what adrenal fatigue actually is, how to recognize it, and what to do about it.

Understanding Your Adrenal Glands

Your adrenal glands sit on top of your kidneys. They're small—about the size of a walnut—but they're essential for survival.

Each adrenal gland has two distinct parts:

The Adrenal Cortex (outer layer):

Produces steroid hormones made from cholesterol (specifically LDL cholesterol, which isn't "bad" despite its reputation):

• Cortisol: Regulates stress response, inflammation, blood sugar, and immune function
• Aldosterone: Controls sodium, potassium, and fluid balance (affects blood pressure)
• DHEA: The "anti-aging" hormone; precursor to testosterone and estrogen
• Testosterone and Estrogen: Sex hormones that affect energy, muscle mass, libido, and mood

The Adrenal Medulla (inner core):

Produces catecholamines (fight-or-flight hormones):

• Epinephrine (adrenaline): Increases heart rate, dilates pupils, shunts blood to muscles
• Norepinephrine (noradrenaline): Increases blood pressure, sharpens focus, prepares you for action

When someone cuts you off in traffic and your heart starts racing, your palms sweat, and your vision sharpens—that's your adrenal medulla activating.

When you're under chronic stress and your body can't control inflammation, regulate blood sugar, or fight infections—that's your adrenal cortex failing.

Signs of Adrenal Fatigue

Adrenal dysfunction produces a wide range of symptoms because cortisol affects nearly every system in your body.

Common adrenal fatigue symptoms:

The most common response to this list: "Everyone has at least some of these!"

Yes. That's the problem. Adrenal dysfunction is epidemic.

Just because something is common doesn't make it normal or healthy.

Why Adrenal Fatigue Causes These Symptoms

Cortisol is your master stress hormone. It regulates inflammation, immune function, blood sugar, and energy production.

When cortisol production is adequate, your body handles stress efficiently. When cortisol is depleted, everything falls apart.

Cortisol and Inflammation

Cortisol is your body's primary anti-inflammatory hormone.

When you encounter an allergen, pathogen, or injury, your immune system releases inflammatory mediators (histamine, cytokines, prostaglandins). Cortisol downregulates this response and prevents inflammation from spiraling out of control.

When cortisol is depleted:

• Inflammation runs unchecked
• Seasonal allergies worsen
• Asthma attacks increase
• Autoimmune flares occur
• Joint pain and muscle aches intensify

Your immune system becomes hypervigilant because cortisol isn't there to regulate it.

Cortisol and Blood Sugar

Cortisol raises blood glucose during stress by triggering gluconeogenesis (making glucose from protein) and inhibiting insulin.

This is protective short-term. It ensures your brain has fuel during emergencies.

When cortisol is depleted:

• Blood sugar drops between meals (hypoglycemia)
• You crave sugar and carbs constantly
• Energy crashes in the afternoon
• You wake at 2-4 AM (cortisol should rise slightly overnight to maintain blood sugar; when it doesn't, you wake)

For more on blood sugar dysfunction symptoms, take the blood sugar questionnaire. Adrenal fatigue and blood sugar dysregulation are inseparable.

Long-term, cortisol dysfunction contributes to insulin resistance and diabetes.

Cortisol and Energy

Cortisol helps mobilize energy from stored fat and protein. It keeps you alert during the day and supports mitochondrial function.

When cortisol is depleted:

• You can't get out of bed in the morning
• Afternoon fatigue hits like a wall
• You need caffeine to function
• Exercise feels impossible

You're not lazy. Your adrenals can't produce the hormones needed for energy metabolism.

Cortisol and Immune Function

Cortisol modulates immune response. Too much cortisol suppresses immunity (making you vulnerable to infections). Too little allows immune overactivation (autoimmunity, allergies).

When cortisol is depleted:

• You catch every cold and flu that passes through
• Infections take longer to resolve
• Autoimmune conditions flare
• Allergies and asthma worsen

What Causes Adrenal Fatigue?

Adrenal fatigue develops when stress demand exceeds cortisol supply for months or years.

Common triggers:

• Chronic psychological stress (work, relationships, finances)
• Physical stress (overtraining, lack of sleep, chronic pain)
• Metabolic stress (blood sugar dysregulation, poor diet)
• Inflammatory stress (chronic infections, autoimmune disease, food sensitivities)
• Environmental stress (toxins, poor air quality, mold exposure)

The modern lifestyle is designed to exhaust adrenal function. Chronic stress + poor sleep + inflammatory diet + sedentary behavior = depleted cortisol reserves.

How to Restore Adrenal Function

Adrenal fatigue is reversible if you address the root stressors.

Step 1: Stabilize Blood Sugar

This is the single most important intervention.

Blood sugar swings force your adrenals to work overtime compensating with cortisol surges. Stabilizing glucose takes enormous pressure off adrenal glands.

How:

• Eat protein and healthy fats at every meal
• Eliminate sugar and refined carbohydrates
• Eat within an hour of waking
• Don't skip meals
• Focus on nutrient-dense whole foods

For comprehensive nutrition strategies that support blood sugar balance and reduce adrenal stress, visit the Fuel Your Body pillar page.

Step 2: Prioritize Sleep

Cortisol follows a circadian rhythm: high in the morning (to wake you up), low at night (to allow sleep).

Adrenal fatigue disrupts this rhythm. You're exhausted in the morning and wired at night.

How to restore rhythm:

• Go to bed by 10 PM (cortisol starts rebuilding between 10 PM and 2 AM)
• Sleep 8+ hours
• Avoid screens 1-2 hours before bed
• Keep bedroom dark and cool

Step 3: Reduce Chronic Stress

You can't eliminate all stress. But you can reduce unnecessary stressors and improve stress resilience.

How:

• Say no to non-essential commitments
• Practice breathing exercises, meditation, or gentle movement
• Spend time outdoors
• Reduce stimulant use (caffeine, nicotine)
• Address emotional or psychological stressors with therapy or coaching

For more on supporting your body's stress response systems, visit the Regulate Your System pillar page.

Step 4: Support Adrenals with Targeted Nutrition

Certain nutrients support adrenal function and cortisol production:

• Vitamin C: Required for cortisol synthesis (adrenals have the highest concentration of vitamin C in the body)
• B vitamins: Support energy production and neurotransmitter synthesis
• Magnesium: Calms nervous system and supports HPA axis
• Sodium: Supports aldosterone function and blood pressure regulation (don't fear salt if you're adrenally fatigued)
• Adaptogenic herbs: Rhodiola, ashwagandha, holy basil (work with a practitioner for dosing)

Step 5: Test and Personalize

Adrenal fatigue exists on a spectrum. Some people have mild dysfunction; others are nearly non-functional.

Comprehensive testing includes:

• Salivary cortisol (4-point test): Measures cortisol at waking, noon, evening, and bedtime to assess circadian rhythm
• DHEA: Should be balanced relative to cortisol
• Fasting glucose and insulin: Reveals blood sugar dysregulation
• Thyroid panel: Hypothyroidism mimics adrenal fatigue

Work with a practitioner who understands functional adrenal assessment. Standard blood tests (morning cortisol only) miss the majority of dysfunction.

The Bottom Line

Adrenal fatigue isn't "all in your head." It's a physiological state where your stress response system can't keep up with demand.

The symptoms—fatigue, allergies, blood sugar crashes, inflammation, poor immunity—are real.

The solution isn't another stimulant or pharmaceutical band-aid. It's removing stressors, supporting recovery, and giving your adrenals the resources they need to rebuild.

Stabilize blood sugar. Prioritize sleep. Reduce stress. Test comprehensively.

Your adrenals can recover. But you have to stop demanding more than they can produce.

Experiencing chronic fatigue, allergies, or blood sugar issues despite trying everything? Dr. JJ Gregor uses Applied Kinesiology and comprehensive adrenal testing to identify the root causes of adrenal dysfunction in his Frisco, Texas practice. Schedule a consultation to restore your stress response system.