What Causes Adrenal Fatigue?

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This incorrect belief has contributed to a widespread lack of understanding surrounding adrenal fatigue and its causes. To effectively improve the well-being of the human population, awareness of the adrenals and possible contributors to adrenal fatigue must be improved.

An Overview of the Adrenals and Adrenal Fatigue

The adrenal glands are about the size of a walnut and rest just above the kidneys. These small but important structures produce over 150 hormones that regulate numerous elements of health. Some notable areas of adrenal influence include, blood sugar regulation, anti-inflammatory action, immune function, metabolism, mood, fluid and electrolyte balance, and maintaining healthy blood pressure. However, of their many roles, perhaps the most important function of the adrenals is regulating the body’s stress response.

Learn more about the adrenals in this health chat from Dr. Evans.

Identifying Adrenal Dysfunction

As mentioned above, the adrenals influence many areas of health. As such, poor adrenal activity can lead to a wide array of symptoms. In some cases, individuals may be able to recognize adrenal fatigue or poor adrenal function through the following symptoms:

  • Anxiety
  • Cravings for salty or sweet foods
  • Difficulty handling stress
  • Dizziness when standing (low blood pressure)
  • Loss of libido
  • Moodiness or irritability
  • Muscle aches and weakness
  • Palpitations
  • Sensation of feeling “wired and tired”
  • Sleep difficulties or insomnia

Symptoms of adrenal fatigue may develop slowly over time. It is often the case that patients do not even recognize the signs of adrenal dysfunction until their condition has already reached a a state of severity. Furthermore, symptoms may not manifest until a particularly stressful event causes the adrenals to crash thereby causing a spike in symptoms. However, there are many factors apart from individual stress events that promote adrenal fatigue and the possibility of a crash.

Potential Contributors and Causes of Adrenal Fatigue

Adrenal fatigue typically develops over a long period of time. As various stressors and contributors continue to compound, the adrenals become increasingly exhausted. If the adrenals are already fatigued, a high stress event can trigger an adrenal crash. This can prompt the development of serious conditions and potentially life-threatening symptoms. There are many factors in everyday life that can contribute to adrenal stress and subsequent fatigue.

Physical Stress

The adrenals respond to all forms of stress including physical pain, exertion, and trauma. In some cases, major accidents or events can damage the body thereby triggering the release of various hormones from the adrenals. This can lead to adrenal fatigue or trigger an adrenal crash if the glands are already exhausted. It is important to note that even common physical stressors such as working out too hard or straining a muscle can tax the adrenals and contribute to adrenal fatigue.

Emotional or Mental Stress

Mental state and psychological stress can also put undue strain on the adrenals leading to adrenal exhaustion. It is common for those who regularly experience stress in their professional and/or personal life to suffer from some degree of adrenal insufficiency. Additionally, particularly emotional events and major life changes such as divorce, loss of a loved one, or change in employment can induce a high degree of stress and further drain the adrenals.

Lack of Sleep or Poor Sleep Quality

Perhaps the most common symptom of those suffering from adrenal fatigue is difficulty sleeping and inadequate sleep. Because the adrenals and sleep quality mutually influence one another, a lack of sleep can quickly start a recurring sequence of degrading adrenal function and sleep quality. As sleep quality declines, physical and mental stress increases thereby increasing adrenal strain and the risk of exhaustion.

Imbalanced Diet

Diet has a broad influence over many aspects of health including adrenal function. Processed foods, sugars, and caffeine all encourage the adrenals to release of cortisol, adrenaline, and insulin. An excess of these hormones can contribute to adrenal exhaustion and other serious health issues. Additionally, environmental toxins and pesticides that are used in the production of processed foods can encourage adrenal dysfunction. Ideally, a patient’s diet limits consumption of these foods and replaces them with more whole foods, healthy fats, and proteins, while also reducing exposure to disruptive toxins.

Learn more about the adrenal fatigue diet here.

Chronic Conditions

Continuous physiological stressors are a primary contributor to adrenal fatigue. For this reason, those suffering from chronic illness often have adrenal imbalances. For example, individuals with chronic fatigue syndrome, fibromyalgia, recurrent infections, and/or hormone-disrupting conditions such as peri/menopause and hypothyroidism frequently experience some degree of adrenal disruption, which can contribute to adrenal fatigue. Worse still, adrenal fatigue can perpetuate chronic illness, which creates a cycle of declining adrenal function.

Resolving Adrenal Insufficiency

The treatment for adrenal fatigue should include lifestyle improvements that reduce physiological stress. Patients may want to focus on physical and mental relaxation by engaging in activities such as yoga, meditation, sauna, massage, or stress-relieving hobbies. Additionally, enjoying low intensity exercise such as walking, short bike rides, or light jogging can also be beneficial. Replacing inflammatory foods, processed items, and sugars with a balanced diet composed of whole foods is also important. Making sleep a priority and practicing good sleep hygiene should be a keystone of any adrenal treatment protocol. Finally, any underlying chronic conditions need to be addressed by a qualified physician.

Protecting Adrenal Function to Achieve Overall Wellness

Because of their significant influence, irregular adrenal activity can lead to serious system wide dysfunction. A common yet frequently overlooked form of adrenal disruption is adrenal fatigue also known as adrenal insufficiency. Unfortunately, there are many physiological stressors that contribute to adrenal exhaustion and subsequent crashes. Being aware of factors such as emotional and physical stress, poor sleep quality, unhealthy diet, and chronic conditions is important for protecting adrenal function and by extension overall health. Identifying these elements in your life and taking steps to improve them can help prevent and alleviate adrenal dysfunction.

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your adrenal dysfunction and its underlying cause. If you have symptoms associated with adrenal fatigue, call us at 877-508-1177 to see how we can help you!


1. Kent Holtorf, MD. “Diagnosis and Treatment of Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysfunction in Patients with Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).” https://www.holtorfmed.com/download/chronic-fatigue-syndrome-and-fibromyalgia/Diagnosis_and_Treatment_of_HPA_Axis_Dysfunction.pdf

2. Kent Holtorf, MD. “Adrenal Fatigue Testing.” https://www.holtorfmed.com/download/other/Adrenal-Testing.pdf
3. Kent Holtorf, MD. “Adrenal Fatigue Treatment Options.” https://www.holtorfmed.com/download/other/Adrenal-Treatments.pdf.

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.