If you have adrenal fatigue, should you go high carb? Low carb? Moderate carb? Ketogenic? Atkins? South Beach?
What is the best diet for adrenal fatigue?
With so much information on nutrition, what’s the best plan to follow if you have adrenal fatigue?
HPA axis dysregulation (HPA-D) is the more accurate term for the syndrome often referred to as adrenal fatigue. It is characterized by a diverse range of signs and symptoms, including, but not limited to:
- Poor stress tolerance,
- Muscle aches,
- Increased susceptibility to the flu and/or the common cold.
- High levels of perceived stress
- This includes work, relationship, financial, etc. stresses. Perceived stress is likely what comes to mind when you think of stress.
- Circadian disruption
- This includes too much exposure to light at night, not enough exposure to light during the day, travel across time zones, and any other sleep irregularities or interruptions.
- Blood sugar dysregulation
- This includes high blood sugar, low blood sugar, and even large fluctuations between high and low blood sugar. It’s unlikely you’ll “feel” this occurring. Therefore, testing is essential.
- This includes food allergies/sensitivities, and/or hidden gut infections like SIBO.
For a deeper dive into what else causes adrenal fatigue, check out this post.
Supplements are an important part of the treatment of adrenal fatigue, but diet and behavioral/lifestyle changes are absolutely crucial for recovery. Put simply, you cannot supplement yourself out of adrenal fatigue.
The first step in successfully treating adrenal fatigue needs to be nutrition. Poor diets/nutrition can cause inflammation and/or blood sugar imbalance. Addressing diet alone can solve 50% of the common causes of adrenal fatigue.
The adrenal fatigue diet
Disclaimer: everyone has a unique genetic background. As such, the diet that is best for you is likely somewhat different than the diet that is ideal for me. In writing recommendations, I have chosen to stick to general dietary principles. These recommendations will work for the majority of patients. If you’re not noticing success with the below recommendations, please find a qualified functional medicine practitioner to work with!
The first and most important dietary recommendation for those with adrenal fatigue is to eat real food. More specifically, food that is capable of spoiling. If your food can sit on a shelf for months, don’t eat it! It’s processed. And processed foods are one of the main causes of adrenal fatigue.
Processed foods are low in nutrition and high in calories. Regular consumption of these foods will increase inflammation and cause blood sugar imbalances (two of the main causes of adrenal fatigue). I recommend those with adrenal fatigue follow a Paleo or Mediterranean dietary template. For more information on how to start a paleo diet, please see this post.
If the thought of starting a paleo diet feels overwhelming, start small. You don’t need to be following a strict paleo diet overnight. Instead, start with a gluten-free diet. And take as long as you need to get there. To learn how to comfortably go gluten-free, check out this post.
Transitioning to a whole or real foods diet is the first step to successfully overcoming adrenal fatigue. Once you’re successfully eating whole foods, it’s then time to examine the quantity of your food!
The ideal food quantity for adrenal fatigue
A macronutrient is a science-y word to describe any substance we as humans need to regularly consume in order to stay alive. Macronutrients are broken down into three types:
Macronutrient ratios are simply different ratios of proteins to fats to carbs. For example, a ketogenic diet is a very low carbohydrate diet. About 5% of daily calories come from carbohydrates while on a ketogenic diet. For someone on the ketogenic diet consuming 2000 daily calories, only 100 calories (5%) would come by way of carbohydrates. The other 95% of calories would come from fats (65-70%) and proteins (25-30%).
The other extreme is the standard North American diet. The average citizen of North America gets 40-60% of her calories from carbohydrates (most of which are processed). On the same daily 2000 calorie diet, this person would consume 1000 calories (50%) just from carbohydrate sources. The remaining 50% is often equally divided between fat (25%) and protein (25%).
The two diets lay at the extreme ends of the dietary spectrum. In general, those with adrenal fatigue don’t do well with extremes. In this condition, moderation is key. My general rule of thumb for those with adrenal fatigue is to eat a moderate carbohydrate diet. A moderate carbohydrate diet consists of about 15%-30% daily calories coming from carbohydrate sources.
High levels of dietary carbohydrates often exacerbate blood sugar imbalances. (1) Refined food products have been shown to cause chronic levels of inflammation. (2) Therefore, the ideal diet for adrenal fatigue would include a reduction in both refined food products and carbohydrates.
Other dietary tips for those with adrenal fatigue
Eat adequate protein, especially in the morning:
Higher-protein diets reduce cravings and seem to have a regulating effect on blood sugar. You should eat at least 15 percent of total calories as protein (75 grams of protein on a 2,000-calorie diet or 95 grams on a 2,500-calorie diet). You should also eat a high-protein breakfast (40 to 50 grams of protein). This has a stabilizing effect on your blood sugar throughout the day.
Having bacon and eggs for breakfast will serve you far better than having coffee and a muffin. The high fat and protein content in bacon and eggs will keep you feeling full until lunch. The coffee and muffin will leave you feeling ravenous in about an hour. It is a perfect example of a large swing in blood sugar.
Eat frequently throughout the day:
To keep blood sugar levels stable, you should either eat five or six small meals per day or three regular meals with snacks in between. Choose whichever approach suits your preference and lifestyle best. Snacks and meals should always have some protein and fat. Please avoid eating solely carbohydrates. If your snack is an apple (carbohydrate) trying combining it with cheese (fat and protein) or a nut butter ( fat).
Beef jerky and macadamia nuts are my go-to snacks. They’re incredibly low in carbohydrates which will help to stabilize your blood sugar. Try to avoid refined sources of carbohydrates as snacks. This includes bagels, muffins, chips, and candies.
Avoid excess dietary potassium:
If your adrenal fatigue is severe and you experience low blood pressure, you may want to avoid high-potassium foods, since potassium can lower blood pressure. Foods high in potassium include bananas, dried figs, raisins, dates, potatoes, and sweet potatoes.
Ensure you get adequate salt intake:
Extra salt in the diet can help increase blood pressure. If your adrenal fatigue (HPA-D) has caused you to have low blood pressure, you may want to start your day with a glass of water with one-half to one teaspoon of sea salt in it. I also recommend seasoning all of your food with salt to your palate’s preference.
Avoid caffeine and alcohol:
Caffeine is a stimulant, and it places additional stress on the body. Alcohol stresses the liver, which often functions suboptimally in adrenal fatigue (HPA-D). It’s best to avoid caffeine entirely and either limit alcohol consumption to two to three drinks per week or avoid it completely until your adrenals recover.
Vitamins and minerals for adrenal fatigue
The adrenals have very high tissue concentrations and uptake of vitamin C. Therefore, it’s important that you get enough through your diet.
- Fruit sources: papaya, strawberries, pineapple, oranges, kiwi, cantaloupe, raspberries, blueberries, and cranberries
- Vegetable sources: broccoli, Brussels sprouts, cauliflower, kale, cabbage, and bok choy
Many biochemical pathways for making steroid hormones (including cortisol) are B-vitamin dependent. Therefore, high levels of b-vitamin intake are absolutely essential for those with adrenal fatigue. There are specific genetic markers that can make it challenging for you to get enough b vitamins. In these cases, supplementing with a methylated b-complex vitamin can be of great help.
- Top food sources: liver, clams, seafood, dark leafy greens, lentils, mushrooms, spices, poultry, egg yolks, peppers, squash, nuts, and seeds
Low intake can cause increased renin, cholesterol, triglycerides, and all-cause mortality. Symptoms of low sodium can include lethargy, nausea, and hypotension – sounds a lot like adrenal fatigue, doesn’t it? Keeping your salt intake up is essential if you have adrenal fatigue.
- Take one-half to one teaspoon of sea salt in a glass of water upon rising and add salt and/ or kelp flakes to food if needed.
High levels are associated with lower blood pressure, and low levels or a potassium deficiency is associated with hypertension, high blood sugar, and being overweight.
- Top sources: potato, halibut, plantains, rockfish, sweet potato, beet greens, bananas, sockeye salmon, acorn squash, avocado, parsnips, pumpkins, kohlrabi, duck, and mushrooms
Calcium, zinc, and magnesium:
This multi-formulation has been shown to have stress-lowering effects. I don’t recommend supplementing calcium or zinc. Magnesium supplementation is best done through magnesium glycinate. Aim for 300-500mg/day.
- Calcium: sesame seeds, sardines (with bones), yogurt, collard greens, spinach, cheese, turnip greens, sockeye salmon (with bones), molasses, and mustard greens
- Magnesium: oysters, liver, crab, lobster, beef, lamb, endive, pork, nuts, dark chocolate, and crimini mushrooms
- Zinc: dark leafy greens, nuts and seeds, fish (mackerel), avocados, dairy products (if tolerated), bananas, figs, and dark chocolate
Avoid, or at least cut down on, caffeine when experiencing symptoms of HPA axis dysregulation. No more than one cup of coffee per day. If possible, opt for a dark roast. Dark coffee roasts are much lower in caffeine than blonde or light roasts.
Ok, now you know the best place to start in creating an adrenal fatigue diet. Remember, you don’t have to do this overnight. Take your time. Don’t let the stress of dietary changes contribute to your adrenal fatigue. Move at a pace that is comfortable for you!
Now, I want to hear about your experiences!
What dietary tips/tricks have helped you overcome adrenal fatigue?
Want to know more than your doctor about adrenal fatigue? Check out all of my writings here.
Also published on Medium.