If you get overwhelmed by daily stress and often feel more tired than you think you should, you’re not alone. But don’t be too quick to simply shrug off these symptoms as the price we pay for today’s fast-paced world.

You may be suffering from adrenal fatigue. While feeling stressed out and exhausted could point to a variety of conditions ranging from sleep apnea and anemia to heart problems and depression, adrenal fatigue should definitely be on your radar as your doctor investigates your symptoms.

There is no test for adrenal fatigue, so it’s a controversial diagnosis and some doctors don’t believe that the condition is “real.” But based on my clinical experience with thousands of patients, I am convinced that it is real—and treatable. 

What is adrenal fatigue?

To understand adrenal fatigue, it’s important to review the function of your adrenal glands. Located above each kidney, these walnut-sized glands pump out adrenaline, the fight-or-flight hormone that speeds your heart, boosts your blood pressure and shunts blood from your gut to your muscles—readying you for instant action. If your stress levels don’t let up day after day, then your body’s endocrine system kicks into even higher gear, triggering a hormonal cascade that includes the release of the “stress hormone” cortisol, followed by the hormone glucagon, which raises your blood sugar to supply your brain and muscles with more energy to cope with the extended physiological demands.

The problem is that your hunter-gatherer body hasn’t yet evolved to adapt to the chronic stress of 21st-century living. After years of nonstop stress—marked by cortisol levels so chronically high that they eventually get depleted to chronically low levels—the adrenal glands become literally ­exhausted…the hallmark of adrenal fatigue.

Red flags for adrenal fatigue

If your doctor has taken your medical history and ordered blood tests but hasn’t found a cause for your symptoms, check to see if you have these red flags for adrenal fatigue. Beyond feeling overwhelmed by stress and tired all the time, do you…

Feel irritable when you’re hungry? Exhausted adrenal glands can’t pump out enough cortisol to trigger glucagon production, so your blood sugar levels are often low, which  starves the brain, causing sugar cravings and irritability—aka “hangry.”

Have frequent infections? These may include sore throats and colds that take longer than normal to clear up.Both high and low cortisol levels weaken the immune system.

Ache all over? My patients tend to have constantly tense, achy muscles when their adrenal cortisol levels are unable to supply steady levels of blood sugar for energy after prolonged stress.

Feel dizzy sometimes when you stand up? Cortisol controls blood pressure, and a deficit can result in low blood pressure.

Have a chronic disease? Cortisol interferes with the action of insulin, the hormone that balances blood sugar. This can set you up for chronic ailments such as type 2 diabetes, obesity, heart disease, Alzheimer’s disease and certain cancers. 

If these symptoms apply to you, consider seeing an MD who specializes in holistic/functional medicine (consult The Institute for Functional Medicine, www.IFM.org)…or a naturopathic doctor (check with the American Association of Naturopathic Physicians, www.Naturopathic.org). 

Note: Your doctor can treat you based on your symptoms and results from a salivary cortisol test. Because there is no specific diagnostic test, insurance is unlikely to cover this treatment, but it may help to have your doctor write a letter to your insurer if you respond positively to treatment.

When I identify adrenal fatigue in a patient, I recommend this three-step plan, which typically improves symptoms within one to two weeks… 

Step #1: Tweak your diet

To ease stress on your adrenal glands, avoid…

Sweets. Sugary foods and beverages cause blood sugar levels to repeatedly rise and fall, exhausting your glucose-controlling adrenal glands. 

Coffee. Like sugar, excessive caffeine forces the adrenal glands into action—and eventual exhaustion. Limit yourself to one cup of coffee in the morning and have decaf the rest of the day. Smart alternative: Green tea has components that stop its caffeine from stimulating your adrenal glands, and it contains theanine, an amino acid that promotes calmness and ­concentration. 

For adrenal gland support, focus on…

Protein.Consume ­protein-rich foods at every meal, such as fish, eggs, beans and occasional modest portions of meat. These foods help stabilize blood sugar levels. Also include plenty of vegetables with your protein, particularly leafy greens, which help nourish and repair adrenals. 

Water and salt. Your adrenal glands regulate blood volume and blood pressure, tasks that require plenty of water and salt. But if you have weakened adrenal glands, your body doesn’t adequately retain water and salt. Telltale signs of adrenal burnout are feeling thirsty and urinating more often…and craving salt.

To overcome this imbalance, drink water when you are thirsty. If you crave salt, let your taste buds guide how much you add to your foods.

Important: If you have high blood pressure or heart failure, don’t increase your salt intake without consulting your physician. 

Small meals.To stabilize fluctuating blood sugar levels, go for five (or even six) smaller, high-protein, low-sugar meals daily. 

Step #2: Use supplements

Supplements can help strengthen your exhausted adrenal glands and normalize your blood sugar levels.* 

Adrenal extracts, taken from the adrenal gland of a cow or pig, supply exhausted adrenal glands with the raw material needed for rejuvenation.

Chromium is a mineral that helps normalize blood sugar levels.

Licorice extract slows the breakdown of your body’s cortisol.

Vitamin B-5 (pantothenic acid) promotes cortisol production.

Tyrosine is an amino acid that your body uses to make the neurotransmitters norepinephrine and dopamine.

Helpful: Instead of taking multiple supplements, consider an adrenal supplement such as Adrenaplex from ­EuroPharma’s Terry Naturally or Adrenal Stress End from ­Nature’s Way—both of which contain adrenal extracts and licorice. Note: If you have high blood pressure or diabetes, check blood pressure and glucose levels after two to four weeks to ensure that the licorice extract is not affecting these conditions.

Step #3: Adopt healing ­attitudes

If you have adrenal exhaustion, viewing life as a constant crisis—and you as its victim—will further exhaust your adrenal glands. To reduce stress…

Ask yourself, Am I in imminent danger? The answer almost always will be no, which can help you turn off your fight-or-flight reflex.

Think twice.If you’re having negative thoughts—worried, irritated or sad—focus instead on a positive thought, such as a pet or a hobby you love. Soon, this “switching” process will become second nature.

Practice gratitude.Take a moment to remember what you’re grateful for—the sunny day, a planned vacation, etc. Smart strategy: Make a gratitude list—and when you feel stressed, take three deep breaths, read your list…and relax.

*Take these only under your doctor’s supervision.