Have you heard of the adrenal glands? They are 2 tiny little organs that sit on top of your kidneys and control quite a few actions in your body including your stress response, weight, blood sugar, blood pressure, and immune system. The adrenal glands are really quite incredible in that, as a species, they are our primary survival organs.

Fight or Flight: The Role of the Adrenals

The adrenal glands control our fight or flight mechanism. When we are in danger, or think we are (think: worried your boss is going to fire you, worried about money, worried about your kids, your marriage…), they mobilize all of our resources to fight or get away from that danger.

Historically, as humans, the immediate dangers we faced were typically short-lived. We had to, for example, run away from a saber-toothed tiger that was chasing us. When this system got activated, we pumped out a hormone called cortisol, which made our thinking sharp, gave us energy, and mobilized blood sugar to fuel our muscles. We breathed faster, our heart rate went up, and we got into high-energy action. Once we were safely out of harm’s way, the chemical process resolved and we went back to normal. Insulin, another hormone pumped out in the fight or flight response, mopped that extra mobilized blood sugar back into your cells, your breathing and heart rates went back to normal, and all was once again well in your world.

You‘ve probably seen vivid examples of the fight or flight mechanism on the Nature Channel. Think of watching gazelles around a watering hole. They are calmly drinking when along comes a lion. Suddenly the chase is on and there’s all kinds of action. Once the lion catches a weak or sick or elderly gazelle, what do the other gazelles do? Go right back to calmly drinking at the watering hole as if nothing happened. This is a clear representation of what our nervous systems do!

What Is Adrenal Fatigue?

Now imagine if lions were constantly chasing those gazelles. Eventually the gazelles would wear out and collapse. In nature, constant stress is rare. But in the human world – well, we’ve managed to create all kinds of constant stresses for ourselves! And our health pays the price – first because of adrenal overdrive, and then because of adrenal burnout, or “adrenal fatigue.” One of the many consequences of constant adrenal overdrive is that we pump out too much blood sugar and insulin, eventually becoming insulin resistant and gaining weight – especially around our middle. We also get cravings for fat, sugar, and salt (translate: chocolate covered pretzels and ice cream!), the fuel our adrenal system needs to make this whole reaction work each time.

The adrenal glands act as shock absorbers to our system – they help us bounce back from life’s many stressors. When we’re under too much stress, or unrelenting stress, eventually the adrenals get tired of working overtime. Then we experience something called adrenal fatigue – we get really tired, can’t fight off colds as well, and are less resilient to life’s bumps.

10 Common Signs that You Might be Suffering from Adrenal Stress

The reality is that most of us are under a lot of stress a lot of the time. Home pressures, work pressures, money pressures, kid pressures, and all those inner pressures we put on ourselves to be perfect – eat the perfect diet, do our yoga or workout, excel at work, be the best mom on the block. It’s never ending. Most of us are somewhere on the spectrum between adrenal overdrive and adrenal fatigue.

Here are the 10 most common signs that tell you that you’re experiencing either adrenal overdrive or adrenal fatigue:

  1. You’re having trouble falling asleep even when you’re tired (“tired and wired”) and even when you do sleep, you’re not rested when you wake.
  2. You get irritable or angry really quickly or more often than you want to.
  3. You’re craving sugar/carbs, fat, salt – or all of the above!
  4. You get tired around 3-4 most afternoons, and that’s when you really want something sweet or some extra caffeine.
  5. You’ve been gaining weight, perhaps noticing a spare tire growing around your middle.
  6. You feel anxious or blue.
  7. You’re getting sick more often than you used to.
  8. Your hormones are all over the place, you’re having fertility problems, and perhaps your libido is nowhere to be found.
  9. You’re memory and focus are not what you think they should be.
  10. Your digestive system is a mess.

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Is There a Test for Adrenal Stress?

While there are tests that a functional or integrative doctor can do for adrenal fatigue, if you’re experiencing a few of the above symptoms, you can actually start to treat yourself without special testing. If you do want to get tested, you can ask your doctor to check a salivary or serum cortisol. The best testing looks at a 24-hour range so you can see where your peaks and dips of cortisol occur through the day, which can give your doctor some clues as to what might be going on to trigger these. Some tests, for example, the Adrenal Stress Index, also include DHEA, progesterone, insulin, and fecal sIgA, which look at the effects of adrenal stress on other hormones, blood sugar regulation, and whether your gut is being stressed.

Natural Treatment for Adrenal Stress

Make relaxation a way of life.

Believe it or not, the best treatment for adrenal stress is not supplements or herbs or fancy diet strategies – it is simply learning to practice relaxation. Relaxation techniques such as meditation, mindfulness, and active stress reduction help to let your adrenals know that you are safe – and this allows your system to recalibrate to a lower stress state, including pumping out fewer stress hormones. If you have already progressed from adrenal overdrive into adrenal fatigue, relaxation techniques can help your adrenals to heal and restore themselves.

Practice “sleep hygiene.”

While you might be feeling wired, especially if you are in adrenal overdrive or if adrenal fatigue led you to a 4 pm cup of coffee, your body actually needs 7-8 hours of sleep each night to restore your body and for your adrenals to have time to rebound. See here for complete details on improving your sleep and sleep hygiene techniques.

Keep your blood sugar steady.

When your blood sugar drops, it tells your body you are starving – and this is perceived as danger by your adrenal system. Keeping your blood sugar steady lets your adrenals know you are not in survival mode and that they do not have to go into action. Allowing your blood sugar to dip by skipping meals, living on coffee, and then spiking it up with sugary foods when you’re famished, taxes your adrenals. The most important step to blood sugar balance is starting your day – every day – with a high protein breakfast, and then eating a diet high in protein, good quality fats, and vegetables regularly throughout the day. Don’t let yourself get hypoglycemic and avoid sugary foods that give you a blood sugar spike.

Cut back on caffeine.

Caffeine allows us to push past our natural energy limits and triggers some of the same adrenal chemicals (adrenaline, for example) that get fired up when we’re under stress, leading to increased cortisol production and adrenal overdrive. I know it’s hard to cut back on caffeine when you’re exhausted and hitting that 4 pm slump, but cutting back (or completely cutting it out) is the only way to break that vicious cycle. I can promise you that after you get through caffeine withdrawal (takes a few days, drink a lot of water to avoid headaches!) you will actually have more natural energy, not less!

Exercise – but not TOO much!

Exercise is so healthy for the body and the spirit – but many women, particularly hard core runners and spinners, are getting too much of a good thing. Over-exercising actually contributes to adrenal fatigue, which is why many runners find that they get sick easily and why many over-exercisers have trouble losing weight. So if you’re burning your candle at both ends in your life, and you’re over-exercising, cutting back can help to restore your energy.

Take the right supplements for adrenal support.

A daily multivitamin with B-complex and magnesium as well as a class of herbs called adaptogens are just what this doctor orders for patients with adrenal fatigue! For a multivitamin, I recommend any good quality, food-based one. My personal favorite is Rainbow Light’s Women’s One Daily because it is only 1 tablet/day. The only problem is that it contains folic acid rather than methylfolate, so those with the MTHFR gene polymorphism will need to take a different product. In my practice, for those women we use PhyotMulti by Metagenics.

Adaptogens are a special category of herbs that specifically support, nourish, heal, and replenish the adrenals – whether you have adrenal overdrive or adrenal fatigue. Some of my favorites for women are Ashwagandha (calming, helps with muscle aches, promotes sleep), Rhodiola (especially if you also have anxiety), and Holy Basil (especially immune boosting). To read more about adaptogens, head over to Adaptogens: Herbs for Beating Stress, Fighting Fatigue, and Banishing Cravings.



Get the first chapter of my new book The Adrenal Thyroid Revolution, FREE right here.

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  1. Great blog Aviva. Part of these symptoms also can be signs of thyroid issus. Would love to see you do one on thyca/ thyroid issues as this is thyroid cancer awareness month. Seems with no thyroid and even with meds my adrenals take a lot more punishment. Your friend, follower and thyca survivor. Mechell.

  2. What a fantastic article. I recently saw a dr. of oriental medicine who has been helping me with my adrenals and the herbs have made a tremendous improvement in my life. Thank you for sharing this wisdom.

  3. So how does one know if they have the MTHFR gene polymorphism? Also is this something one should get tested for before trying to conceive since folic acid is so important to the develop of the baby?

    • It’s a very simple blood test that any primary care doctor can run, or that can be done at Lab Corp or Quest. And yes, I think it’s a great idea to get tested prior to pregnancy to see what form of folate would be best for you!

  4. Thank you so much! I’ve been feeling run down, irritable and craving chocolate and olives like crazy for some reason. I do have a problem with Adrenal Fatigue and needed the reminder this morning that I got off the wagon and needed to get back on the Rhodiola! I love reading your blog!

  5. Hi, Just wanted to let you know I enjoyed your talk on the free online summit a few weeks ago – and am so glad I signed up for your newsletters. You are so very knowledgeable and helpful….. I feel blessed to have been “introduced” to you. Keep up the good work, and thank you again! 🙂

  6. Very helpful! Was wondering if you could clarify something confusing to me.
    Is an imbalance in cortisol levels, high or low, indicative of adrenal fatigue? Or is it specifically low?
    The link for “Adrenal Stress Index” mentions scenarios where a cortisol supplement would be beneficial, because cortisol is low in adrenal fatigue. I have also seen different sources say cortisol can be high.

    • High usually means you’re still producing cortisol = good function but you might be having to produce a lot because you are under stress, have inflammation, etc.
      Low is when you have adrenal fatigue from being on overdrive (high)for so long…
      I never give cortisol unless someone has medically diagnosable adrenal disease. Instead I teach mindfulness stress reduction (Heart Math is amazing) and use herbs such as adaptogens and nervous system tonics. Also sleep, yoga, meditation…

        • The go to for sleep and high cortisol is ashwagandha. Lots more to come in my book The Adrenal Thyroid Revolution, and an upcoming free course early this autumn! 🙂

  7. I am so glad I came across your site. The information you’ve shared has helped me a great deal. I have been experiencing all of these symptoms after battling a very bad virus in Feb/Mar of this year. I’ve done a battery of blood tests etc and while finding elevated blood sugar levels and B6/B12 deficiencies it has been difficult to understand what triggered these symptoms and how to fix it. Thank you for sharing and educating 🙂

  8. Aviva, this is wonderful! I am so glad Kris Carr shared your site.
    I was diagnosed with stage three adrenal fatigue about 3 years ago. It was a bumpy, confusing road… but I never gave up, did some mega research and made it out on the other side.
    These days I’m a passionate women’s health enthusiast. Slowing down.. so important and loving ourselves up! I’ve been blogging about the experience and I’m always looking for a good article to share when people email me questions…This is it! I look forward to getting your emails Aviva! You inspire me! TY, TY! Elyse’

    • Thank you Elyse! Do keep me posted on what types of info you are looking for. I’m always looking for blog angles that meet the needs of my tribe!!! And thank you to Kris! 🙂 Warmest wishes, Aviva

    • Hi Elyse, would love to read your blog and talk to you more about your experience with adrenal fatigue. I’ve been diagnosed with stage 3, but haven’t really found a knowledgeable dr here! So frustrating! Please, if you could email me back, I would be so appreciative!l haven’t had a much luck with people responding to my questions or my requests for sharing. Thank you!

  9. For women, buying the PhytoMulti by Metagenics, would the formulation with or without iron be better? Thanks! Great article, as usual!

  10. I know my adrenals are messed up, I have apple shaped weight gain, ie my arms and legs are thin but my wiast thick and I gain all my weight above the belly button not on hips and bottom like normal healthy women, I over heat and sweat buckets, I am infertile, easily angered and stressed, don’t sleep without medication, i crave sweets and carbs, oh that’s me. I also get a lot of colds.

    • Hi Ali, given your symptoms I’d actually get your 24 hour cortisol level checked by your primary doctor — you could have a more serious adrenal problem than just adrenal fatigue. IF all of that looks normal, please please get a copy of The Blood Sugar Solution in addition to using the herbs in my blog! It can help you to reduce insulin resistance which is so important!

  11. Which PhytoMulti should a gal in her childbearing years use – with or without iron? Also, there is a warning on the package about using that multi while nursing/pregnant because of the Vitamin A content. Should nursing/pregnant moms avoid it? Thanks!

  12. This describes my husband, he has 8 of the 10 signs. I know that your recommendation for supplements is for women. Can you give some suggestions for men.

  13. Hi Aviva!
    I just happened to see this and wanted to know more, as I can feel my adrenals are tired. I’M tired!! But this is also IMMENSELY helpful for me to help my 16 yr old son with his high functioning autism and ocd issues. His stress levels are horribly high with his anxiety disorder, and he just won’t listen to me (I’m most definitely the Charlie Brown teacher voice to him!). So if I read some of this to him, hopefully he’ll hear in a different way, how to take care of himself.
    MANY thanks Aviva. Take good care ~ Aly

  14. Hello Aviva! I love reading your wisdom when I have the chance. Thank you so much for all you do. I have a question: “The only problem is that it contains folic acid rather than methylfolate, so those with the MTHFR gene polymorphism will need to take a different product. In my practice, for those women we use PhyotMulti by Metagenics.”

    I’m hearing more and more about this MTHFR, but a lot of the info I’m finding seems fringe to me. Could you elaborate or post links to some quality research?



    • Hi Melissa! So great to hear from you!!! It’s been a long time. The MTHFR gene is involved in the use of B12 and folate. The idea is that when it is intact, you get the benefits of those nutrients and recycle your homocysteine back to methionine. When you have a change in the gene, called a SNP or single-nucleotide polymorphism, as is common (30% of all people have one SNP and 10% have two SNPS) you don’t properly use these vitamins, and you end up with higher homocysteine, which is inflammatory to the vasculature. The MTHFR snp has been associated with neuro issues from neural tube defects in embryos to autism, heart disease and strokes in adults, miscarriage, and preeclampsia. I’d not get too scared, but you can easily check to see whether you or the kids have the MTHFR snp and if anyone does, simply supplement with methyl-folate rather than using folic acid as a supplement. It’s a standard blood test.You can also check homocysteine levels and if high, use a higher level of methylfoltate to bring it down. I see it all the time and it’s a treatable issue and one worth being aware of for health promotion and disease prevention.

  15. Hi Aviva. After every medical test under the sun I was diagnosed with Adrenal Fatigue when I finally went to a natural doctor. I have been sick since December of 2014. Some days I feel pretty good but I still have alot of days where I am in bed. I sleep from 1 to 4 days at a time. It is such a deep sleep that I explain it as when you go to the doctor and are under the twilight. I don’t hear anything!! The phone ringing, house alarm going off, dog barking. At times my husband cannot wake me up. It’s really scary. I feel like I should be getting a lot better than what I am by now. I switched to all organic, grass fed diet, take Prenenolone, Adrenal mess per doctor plus other vitamins. I have 2 young boys and feel awful that I’m always in bed and can’t be the mom I want to be. I can’t work either. I am open and would love any suggestions!!! Thank you so much!

  16. I have many of these symptoms. About a year and half ago I suddenly gained 50 pounds without just cause. I had my thyroid checked, hormones and even went to a sleep specialist with no results. Is it possible they didn’t check my adrenal levels? Seriously I’m 34 and I have zero libido. I have kidney stones so my doctor doesn’t want me taking supplements.

  17. Dear Aviva Romm

    Thank you so much for posting this. I am a 5 times stage 4 cancer survivor of Adrenal Cortical Carcinoma. It is not very often I come across a post related to the rare cancer that I have. I was diagnosed with this in my 20’s after they removed a very large tumor that was about the size of a large grapefruit. Along with the tumor they removed the right adrenal gland and as you know we only have two. And while we can live with one it can also be a challenge.

    Just like in your post I was a runner and yes lived a very stressful life. I think for most of my life I have been in fight or flight mode. Always taking care of others and making sure their needs were met first. This also caused the cancer to metastasize to my right lung three times and then to my chest area where it was deemed inoperable so my only option at that point was radiation. I did the most aggressive form of radiation treatments that were to be receptive to the number of recurrences I had experienced. I did radiation 2 times a day for 6 and a half weeks, and left with the knowledge that if more cancer occurred in that area that my options were up. After the aggressive radiation treatment failed I was given 9-13 months to live. I was told to go home and get my affairs in order.

    I was offered an oral type of chemo that was only 2% effective at that time for the stage and type of cancer I had. I was already a small girl in size so declined the chemo because I felt I would have had nothing to fight with. We know how chemo can attack all the good in the body. I had only been married at that point for 5 years and in between the adrenal being removed and it metastasizing to the lung I was blessed to be given the opportunity to be a mother. After the first surgery I was told that my chances were not available any longer and of course that threw me into depression. The first surgery was in October of 1992 and in Feb of 93 I became pregnant with my daughter who by the grace of God was born healthy and I had no complications during pregnancy. It was after I gave birth that I realized that there was a possibility that my cancer was back. I had once again had unexplained weight gain, acne break outs, mood swings, thinning of hair, fatigue, and loss of my productive cycle, but this time i was not pregnant as my tubes had been tied.

    After everything I had been through and all the emotions my family were exposed to I declined the chemo because I did not want my husband and daughter to remember me in the way that the chemo would ravage my body. My Daughter was 2 by then and my husband had just lost both his parents 9 months from each other.

    I chose to live my 9-13 months in the best way I thought at the time. I turned to juicing , taking mega doses of vitamin C and trying any weird little thing out there that would not add to my sickness. I also incorporated more spirituality into my everyday practice and prayer. That was by then 1997/1998. It is 2015 and I am still here but it has been a long battle with the side affects from the many surgeries and the post surgical conditions that came along with them. Mostly chronic pain and fatigue.

    Your post could have not come at a better time as I have had many stressful events occur as well as almost every single symptom that has been listed including fatigue, mood swings, and the very foods mentioned of chocolate covered pretzels and yes Ice cream.

    Now that I am down to one adrenal gland this was very much an eye awakener to read your information. As I have been suffering with chronic fatigue, stress and many other things. They say God places people and signs in your path and it is our jobs to be open to see them and also our job to take from them what needs to be taken. I want you to know that you may very well have saved a life tonight, and that life being mine. Life is a precious thing that all of us are guilty for taken for granted. We are not always lucky to be guided to a post such as yours, that brings to our attention, that we only have one life to live, and if we are lucky … a life time to live it in.

    I was originally directed to your post through Jill Dahl’s post: http://www.vancitybuzz.com/2015/01/warning-hanging-in-there-destroying-your-health/

    Many Blessings to both of you!

    Wishing you a Magical Weekend,

    Michelle Colon-Johnson
    Founder of 2 Dream Productions, Inc.

      • Thanks for you kindness, Aviva. I had actually forgotten I wrote such a long reply on your blog. I just noted the time and it was of course on a night I could not sleep and stressed out from the fact. Sending you many blessings and a Magical week! -Michelle

  18. Appreciate all the adrenal info. I’m 25 weeks with twins, and 5 weeks post laser for twin to twin transfusion syndrome. I know I had adrenal fatigue before pregnancy. It got worse after a 2 week trip to South America where I picked up a virus, just before conception. The surgery, high risk stress, bed rest, large family, husband’s broken ankle, finances, etc and an out if state move coming up have made me weak and exhausted. I’m eating protein frequently and taking good vitamins and methyl folate and b12, but what else can I do? Our Dopplers are showing possible anemia/TAPS and the drs stressed how important adrenal function is. Thank you for any wisdom. I can’t avoid the situations, but I do have a positive outlook.

  19. I was diagnosed with primary aldosteronism last fall after a series of testing, including AVS. I was not a candidate to have an adrenal gland removed. I was put on a low dose of spiroaldactone. While this medication has my high blood pressure under control, none of the other symptoms has changed. I am still over weight and have difficulty losing weight. My sex drive is still non -existent, I have the sugar and salt cravings and I am tired all the time. Any thoughts on how to help me with the remaining symptoms? I was also just diagnosed with primary hypaparathyroidism ( high calcium levels) and will be having one of my parathyroid a removed at the end of this month.

  20. I have been treated for my hypothyroidism for the past 7 years after the birth of my twins and STILL have all of these symptoms despite my lab results coming back around a 1.9. Would it be wise to be checked for this?

    • Hi Heather, Yes, would be a good idea — also check FT3, FT4, thyroid antibodies, and RT3. You might be producing TSH ok but having peripheral conversion issues that are keeping you from having more energy…And then there’s being mom to twins – that’s gotta’ be a bit of work, too! 🙂

  21. Hi! When using the Phytomulti do you also need to add a magnesium & b-complex supplement? I have heterozygous MTHFR and am still trying to figure out how to properly use supplements. If so, what form of magnesium or b-complex would you recommend?

    Love your blog, it has been such a help to me!


  22. Aviva, thank you for all you do! I can’t tell you how much you have helped me and my family with your articles and research! I was wondering if you have a dosage protocol for the adrenal fatigue adaptogens for children. I’m thinking I would like to supplement them and help them with this issue as well. Thank you for any info.

  23. Hi there! Curious the difference in adrenal overdrive and adrenal fatigue? I’m super hyped up and although tired not able to relax or sleep. My DHEAS is Triple high, slightly elevated cortisol, blood sugars all over the place. What do you suggest for adrenals that are in overdrive. Feel like I have anxiety 24-7 and I have not always been like this!? Started about a year ago and got really bad in October. What do you suggest to calm the adrenals and help with sleep?

    • There sure is! Overdrive is when you’re in the stage of feeling wired, agitated, super stressed, hypervigilant, anxious. Over time, the body gets tired of staying in “overdrive” and one becomes exhausted – what is usually referred to as adrenal fatigue. There’s a whole section on this in The Adrenal Thyroid Revolution. Get your copy at http://www.avivaromm.com/bookbonus. 🙂

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