Most people know very little about their adrenal glands, but their proper functioning can tnve a profound effect on health.

The adrenal glands, located on top of the kidneys, are only about the size of walnuts but produce more than 40 different hormones, including the stress hormones cortisol and adrenaline. Cortisol is involved in a variety of functions, including adapting your body to—and protecting it from—stress, while adrenaline is a short-acting hormone involved in the "fight-or- flight" response.

People who experience high levels of chronic stress can develop "adrenal fatigue." With this condition, the hormone-producing cells of the adrenal glands are unable to keep up with the unremitting demand of chronic stress, which can be due to serious health problems, for example, or a high-pressure job.

People with adrenal fatigue may experience unusual tiredness, difficulty waking or getting up in the morning along with an afternoon lull, low blood sugar, lack of concentration and, in some cases, mild depression.

Some of these symptoms can be related to a variety of conditions, including general fatigue and thyroid disorders, so it is common for these patients to be misdiagnosed or go undiagnosed. But when these symptoms appear as a group—especially consistent morning fatigue—adrenal fatigue should be suspected.


Most conventional doctors have never heard of adrenal fatigue—or deny that it's a legitimate medical problem. Unlike Addison's disease, a recognized condition in which cortisol levels drop precipitously due mainly to autoimmune problems, adrenal fatigue causes relatively modest declines in cortisol. It isn't life threatening, and conventional doctors rarely test for it.

Research has confirmed the link between low cortisol levels and fatigue. Researchers have noted that patients with low cortisol also have less resistance to disease. They are even less likely to survive a heart attack than those with normal levels.


Levels of cortisol fluctuate in the body throughout the day. Levels typically are highest in the morning, drop in midafternoon, rise slightly about 6 pm, then gradually decrease until the next morning. People with adrenal fatigue may have unusually low cortisol levels at night, which prevents them from getting the deep, restorative sleep they need.

Result: Because a good night's sleep is important for the adrenal glands' recovery, the hormone-producing cells in these glands don't get a chance to recoup their ability to respond to the body's needs. Without adequate rest periods, the cells get overwhelmed and stop producing efficiently.


The blood and urine tests that are used to diagnose Addison's disease aren't sensitive enough to detect adrenal fatigue. Saliva hormone testing is more useful because it measures the amount of cortisol that's actually available to cells.

The test requires saliva samples that are collected by the patient four times throughout the day—usually at 8 am, noon, 4 pm and 11 pm. (Cortisol levels for people who work night shifts would be measured at different times during the 24-hour period) The samples are placed in test tubes and analyzed in a laboratory. It's a good idea to repeat the saliva hormone testing every six months after you have begun treatment.

Based on my experience with adrenal fatigue patients, approximately 80% to 90% will improve significantly in six months to two years after starting a program that includes lifestyle changes and the use of dietary supplements that promote a more normal output of adrenal hormones.

My recommendations…

  • Sleep in at least one day a week. Adrenal cells undergo repair and recovery during sleep. Sleeping in between 7 am and 9 am—even for only one day a week—allows the adrenal glands to rest during a time when high demands are ordinarily placed on these glands.
  • Use herbs. A number of herbs help the body normalize the production of cortisol. Follow label instructions. Try the following herbs until symptoms subside…
  • Licorice root stimulates the adrenal glands to produce more cortisol.

Caution: Because licorice root can raise blood pressure, check with your doctor about blood pressure monitoring.

*The FDA does not regulate herbal supplements. Check with your doctor before taking any of these products. They can interact with prescription medications. Pregnant women should avoid most herbal supplements.

  • Ashwagandha root, from a plant found in India, is an adaptogen, a substance that helps the body return to a normal state. It's helpful for adrenal fatigue because it can stimulate the adrenal glands to produce normal levels of cortisol.
  • Siberian ginseng, a popular medicinal plant grov/n in Siberia, Japan, Korea and China, normalizes adrenal function and increases the body's resistance to stress.
  • Take vitamins. Even though most health-conscious adults take multivitamins, certain vitamins are needed in higher doses to fight adrenal fatigue. Best choices…
  • Vitamin C is used by the adrenal glands to help manufacture stress hormones. Vitamin C is also an antioxidant that helps prevent and repair damage to hormone-producing cells.

Recommended daily dose: 2,000 mg of time-released vitamin C.

Helpful: If your bowel movements become loose while taking high-dose vitamin C, reduce the amount of vitamin C you take daily by 500 mg until your stool is normal. Take a vitamin C supplement that includes 250 mg of bioflavonoids per 500 mg of vitamin C. The combination makes vitamin C more active.

  • B vitamins affect the ability of the adrenal glands to function at peak capacity—this includes, for example, the formulation of coenzymes and other substances required for the production of cortisol.

Recommended daily dose: A B-complex supplement with 50 mg to 100 mg of vitamin B-6...and 75 mg to 125 mg of vitamin B-3.

  • Combine protein, fat and carbohydrates with every meal. Each of these provides energy to cells at different rates. Combining them at each meal ensures that your blood sugar will be stabilized. Good combinations include peanut butter and whole-grain bread...cheese and rice crackers.. .and a chicken sandwich topped with vegetables.

Also helpful: Be sure to chew food slowly—at least 30 times per mouthful—to aid digestion and metabolize nutrients more efficiently.

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