Stephanie Graves

Adrenal Fatigue 101: Symptoms, Phases, and Treatment

adrenal fatigue support

Yes, it is real, and no, your symptoms will not improve after a few days, weeks, or months even. Healing from adrenal fatigue is a journey, BUT with proper nutrition, lifestyle support, healing supplements, and herbs – recovery is possible. Many people, mostly women, are suffering from daily, debilitating fatigue. Contrary to what all your ‘normal’ labs reflect, this is NOT normal and is a red flag that the system has been over-taxed. Quite simply, it is toxic and can be harmful.

What are the adrenal glands?

The adrenal glands are small, rectangular-shaped glands located on top of both kidneys. They produce hormones that help with the regulation of blood pressure, metabolism, energy production, and for today’s discussion, hormones involved in sympathetic reactions. (Remember: sympathetic activation = fight or flight response)

The steroid hormone, cortisol, as well as neurotransmitters, epinephrine, norepinephrine, and dopamine are all produced here and serve as our body’s main reactors to stress. The body, however, cannot differentiate stress in the form of a bear chasing you versus years of unhealed emotional trauma. The same reaction is triggered. 

adrenal glands

What happens in a ‘stress’ response? 

  1. Pupils dilate to allow more light in so that you can see the ‘danger’ in question better
  2. Heart rate and blood pressure increase
  3. Blood vessels to the heart, liver and skeletal muscle dilate, allowing more blood flow to these essential organs
  4. Glycogen, the storage form of glucose, in the liver is mobilized for energy production, raising the blood sugar levels
  5. Blood vessels supplying non-essential organs, like those in the gut are constricted, slowing or stopping digestion completely.  

** You can see now how someone who is chronically stressed likely struggles with blood sugar imbalances AND poor absorption of nutrients. 

The stress response is naturally designed to be turned ON/OFF; it is helpful in certain scenarios. However, when this response is chronically activated…problems arise. 

What are some possible causes of ‘stress’?

  • Parenting
  • Divorce
  • Caring for a parent
  • Unhealed emotional trauma
  • Surgery
  • Job loss
  • Lack of sleep
  • Under-eating / Over-exercising
  • Alcohol or drug use
  • Financial struggles
  • Being a perfectionist
  • Death of a loved one
  • Skipping meals / Low-fat diets
  • Blood sugar swings

The stages of Adrenal Fatigue

Cortisol is normally produced in a specific 24-hour pattern (see below). It should be highest around 10 AM, giving us our ‘get up and go’ to start the day then slowly decrease as the day progresses, reaching its low in the night hours, allowing us to sleep.  

How an individual responds to a stressor all depends on the levels of their cortisol ‘bank account’. Is it starting to dwindle? Or has it been overdrawn? 

normal cortisol curve

Phase I Adrenal Fatigue

In the ‘arousal’ or first stage of adrenal fatigue, the person is in a constant ‘ON” state which results in increased cortisol production. This 24-hour pattern reflects cortisol levels that are consistently elevated across the entire time frame. They may have a new stressor in their life and appear to be adapting well, or maybe mild fatigue is starting to creep in. Naps may or may not be required at this stage and fatigue usually presents in the mornings or mid-afternoon. 

Phase II Adrenal Fatigue

In the ‘adaptation’ or second stage of adrenal fatigue, the cortisol bank account is overdrawn throughout the day due to the presence of a chronic stressor. At this point, the body has lost its resiliency, it cannot continue to take from stores that are exhausted. In this scenario, cortisol levels are normal to low in the morning hours, then blunted for the remainder of the day. As the saying goes, ‘what goes up, must come down’, and that’s exactly what’s happening here. Individuals in the adaptation phase will present with daily fatigue that worsens as the day progresses, PLUS a whole host of other symptoms, including sleep disturbances, weight changes, salt cravings, allergies, low blood pressure, and anxiety. 

Phase III Adrenal Fatigue

In the final, ‘exhaustion’ phase of adrenal fatigue, cortisol levels are at a flatline, they are  LOW ALL DAY. The individual is exhausted all day long. At this point, a nap or vacation won’t suffice. They may also find, in addition to the constellation of symptoms in phase II, poor recovery from exercise, travel, etc, as well as cognitive decline. 

Recovering from adrenal fatigue is possible, and you have to remember, it took you 5, 10, 20 years to get to that level of exhaustion, it’s going to take some time to rebuild. 

adrenal fatigue

Diet and lifestyle support for adrenal fatigue

Regardless of what phase you’re in, there are a few ‘non-negotiables’ when it comes to healing from adrenal fatigue.

  1. Eat enough calories! Far too many women undereat, thinking less calories equals weight loss, however this is not the case. When you undereat, and I’m talking roughly 1800 calories or less per day, your body stays in a stress state. Cortisol levels remain elevated and your body actually holds onto fat so that it has enough energy stores to run from that hypothetical bear. 
  2. Remove sugar from the diet. Blood sugar imbalances plus stress disrupt the cortisol curve, leading to adrenal dysfunction. You want to remove refined sugars, and you may also want to also consider removing refined carbs, grains, and even fruit to support this delicate balance. 
  3. Sleep by 10 PM. This may seem obvious, but without sleep, the entire system falters. It’s the time of day when our body rests and repairs for the day ahead. Without sleep, health risks rise, and stress hormone production stays elevated, leaving you fatigued, and starting the day depleted. Aim for 7-8 hours per night, waking at the same time each day, even on the weekends! 
  4. No caffeine. As painful as kicking the habit is, it is vital. Caffeine dependence worsens the vicious cycle and insomnia. When in reality, what you need is rest. LOTS of rest. 
  5. Gentle exercise. Exercise naturally induces inflammation in the body, but if your adrenals are already taxed, then they cannot address the inflammation. If you run, consider walking or hiking. If you cross-train, consider switching to yoga. The emphasis is on gentleness here, you don’t want to create more stress on the body. If you’re not feeling recovered from your workouts, scale it back even more. 
  6. Remove the stressors from your life! This is hands-down the most important step. If you’re still in an unhappy marriage, employed at a toxic workplace, struggling with perfectionism, continuing to over-exercising, etc. – NO healing will occur. Period. You must remove the stressor(s) to drop into that parasympathetic state we discussed a few weeks back. 

adrenal fatigue treatment

After the non-negotiables are taken care of, we can then introduce various replenishing supplements that can further support the healing based on the phase you’re in. 

Did you find this info helpful? What phase are you in? Which non-negotiable will you tackle first? 

And if you’re seeking more guidance and want a treatment plan based on your individual needs, MESSAGE me, or click here to schedule your FREE 15-min strategy call.

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About me
Hello! I’m Stephanie Graves, Functional Medicine Nutritionist, and Physician’s Assistant.

I educate and empower people who feel hopeless with the current medical model to be the driver on their hero’s journey towards health and healing.

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