This is the final article in an ongoing series. Make sure to check out the previous articles before starting this one:
- What Causes Adrenal Fatigue? (Part I): An Introduction
- What Causes Adrenal Fatigue? (Part II): Blood Sugar
- What Causes Adrenal Fatigue? (Part III): Sleep
- What Causes Adrenal Fatigue? (Part IV): Inflammation
- What Causes Adrenal Fatigue? (Part V): Perceived Stress
By the end of this series, you should have a detailed understanding of the most important mechanisms that can lead to adrenal fatigue. Ideally, you also should now be able to identify which areas are the main source of stress on your HPA axis.
While knowing the cause is indeed important, putting this information into an actionable plan is what will ensure you have a resilient HPA axis for years to come. The remainder of this post will focus on the steps we take here at Flourish Clinic when treating a patient for adrenal fatigue.
The first step required in treatment is identifying whether a patient actually has adrenal fatigue or whether something else is masquerading as adrenal fatigue. We run the DUTCH test with all our patients to establish a baseline measurement of cortisol levels and rhythm.
I do not advise treatment of adrenal fatigue without first having a baseline measurement. The symptoms of high cortisol and low cortisol can be identical, yet the treatment of each is very different. Test, don’t guess. After baseline levels are established, a treatment plan can be implemented. For the purpose of this post, all guidelines will be general treatment principles that should benefit all patients with adrenal fatigue.
After baseline levels are established, a treatment plan can be implemented. For the purpose of this post, all guidelines will be general treatment principles that should benefit all patients with adrenal fatigue.
Please note that specific recommendations are tailored to individual symptoms. No two cases of adrenal fatigue are alike. This can only be done under the supervision of a trained practitioner.
We begin all treatment plans with dietary alterations. The general dietary principles are as follows:
- Eat a moderate-carbohydrate diet:
Most people with HPA-D have problems with blood sugar regulation, resulting in low blood sugar, or sometimes a combination of high and low blood sugar. Focus on a moderate carbohydrate diet, which means about 15 to 30 percent of your calories coming from carbohydrates (100 grams of carbohydrate on a 2,000-calorie diet or 125 grams on a 2,500-calorie diet).
- 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). This has a stabilizing effect on blood sugar throughout the day.
- 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, never just carbohydrates alone.
- 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. These include bananas, dried figs, raisins, dates, potatoes, and sweet potatoes.
- Ensure adequate salt intake:
Extra salt in the diet can help increase blood pressure. If your 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. You should also season your food to taste.
- 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 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.
With the above dietary foundations in place, the next step involves alterations to your behavior and lifestyle:
- Get good sleep and plenty of rest:
There’s nothing more important for those with HPA-D than getting enough sleep and rest. If you feel you need to take naps during the day, do so as your schedule permits. Get as much rest as you can.
- Be smart about exercise:
Overtraining is another common cause of HPA-D. Signs of overtraining include difficulty recovering from workouts, a plateau or decrease in performance, fat gain despite regular exercise, insomnia, restlessness, anxiety, fatigue, muscle or joint pain, frequent illness, and depression. Favor low-intensity exercise such as walking, cycling, swimming, or yoga over high-intensity activities like CrossFit or endurance training. Moderate-intensity strength training, however, seems to be beneficial for those with adrenal issues.
- Be in contact with nature:
Natural environments have rejuvenating and restorative effects, reduce stress, and alleviate mental and physical fatigue. Spending regular time outdoors in a natural environment is especially important for those with HPA-D.
- Get pleasure, play, and connection:
Many people with HPA-D are suffering from stress burnout. They’re exhausted, dispirited, and often feel depressed or “flat.” Pleasure, play, and social connection are all deeply nourishing and restorative on both a physical and emotional level and can provide a powerful antidote to the symptoms of HPA-D.
The above diet and lifestyle alterations can seem overwhelming. There are a lot of recommendations and each requires a great deal of effort. Many have never tried meditation before. Beginning a mindfulness-based practice is a stumbling block for many. The concepts of meditation can feel incredibly foreign.
To better ensure your success, we have found the below guidelines to be helpful in beginning a new mindfulness/meditation practice:
- Start small
If you’re new to meditation, start with just five minutes each day. Gradually increase that time as you become more accustomed to the practice.
- Make it a priority
Consider putting it on your calendar, just as you would any other important task for the day.
- Be gentle with yourself
It’s okay if you miss a day, and it’s okay if you don’t feel like you’re “good” at it.
- Choose a mix of practices
Some days, sitting still on the cushion may feel near impossible, and yoga or another movement-based practice may be a better fit for the day.
Ok, those are our general treatment principles for adrenal fatigue. After a positive diagnosis, these principles are the perfect place to start the journey back to health.
If you have more questions regarding the general treatment strategy for adrenal fatigue, please leave them in the comments section, below.
Also published on Medium.