4 Top Causes of Adrenal Fatigue & What to Do About It

Written By


Expert Reviewed By

Dr. Lauryn Lax, OTD, MS

Dr. Lauryn, OTD, MS is a doctor of occupational therapy, clinical nutritionists and functional medicine expert with 25 years of clinical and personal experience in healing from complex chronic health issues and helping others do the same.

Adrenal Fatigue 1 1 | 4 Top Causes Of Adrenal Fatigue &Amp; What To Do About It

Adrenal fatigue is a buzzword in health world that everyone—from your personal trainer to holistic health practitioners, nutrition experts and supplement labels in Whole Foods—but what is it?

Adrenal fatigue, or “HPA-Axis Dysfunction” as it is called now, is defined as a “collection of nonspecific symptoms” (such as body aches, fatigue, nervousness, sleep disturbances and digestive problems) that causes the body to become hyper (overly) or hypo (under) responsive to outside stressors and triggers.

In other words: Adrenal fatigue is body imbalance (mentally AND physically) from too much stress.

Physiologically speaking, this means you have too high or too low of cortisol levels—your balancing and stress hormone.

Cortisol (the stress hormone) is the key body balancer for dealing with “stress” throughout your lifetime.  Cortisol is ALSO responsible for governing and facilitating the balance of your other hormones and body systems.

The body desires balance above all—not too much stress, nor too little stress either (SOME stress keeps our body vibrant and lively).

  • For instance, exercise or movement is a HEALTHY stressor that our body needs. However TOO MUCH exercise sends our body over the edge and is unhealthy.
  • Hunger and thirst is a HEALTHY stressor—it’s our body’s way of signaling “Nourish me;” “Feed me;” however if we let that hunger or thirst linger for TOO long, then our body gets dehydrated or undernourished (an unhealthy stressor).
  • Drinking an (organic) cup of coffee can be a HEALTHY stressor for an individual for an alert mindset and brain power in the morning. But TOO much coffee (or caffeine) sends our stress hormones into a tail spin.
  • Sweating in a sauna, a tough run or on a hot day is a HEALTHY stressor—our body rids of toxins and excretes waste this way; but if we stay in the sauna OR sweat too long, we over stress our body or become dehydrated.
  • Digestion is a HEALTHY stressor—your body goes to work, work, work, to break down your food; However, if you are running, eating on the go or not chewing your food well, then this leads to UNHEALTHY stress in your gut (inability to digest).
  • Crying or punching bag is a HEALTHY stressor, but when we carry our emotions bottled up inside (without expressing them) or constantly express them without a filter is when stress eats away at us.

While stress is an inevitable, normal part of life (ie. traffic, work deadlines, stimulants like coffee, relationships, finances, to-do lists, and even exercise, etc.), when stress pushes our body past its own limits to “recover” is where we run into problems.

Our cortisol signals our “fight or flight” response, and although it tries to fight for a little while, it eventually can only take so much stress…


If you don’t recover properly from stress, or stress mounts more than normal—at once—say hello to side effects like:

  • Easily irritated or on edge
  • Not “feeling like yourself”
  • Low energy
  • Worry
  • Skin breakouts (despite a “clean” diet and healthy skin care routine)
  • Inability to handle stress
  • Constipation
  • Loose stools
  • Chronic anxiety
  • Hanger before meals
  • Poor workout recovery or lowered intolerance
  • Afternoon energy crashes
  • Brain fog or memory issues
  • Feeling wired and tired at night
  • Needing coffee to function
  • Chronic headaches or migraines
  • Inability to gain weight or lose weight or body fat
  • Loss of muscle tone or inability to put on muscle



  • A sluggish or super fast metabolism
  • Fatigue or tiredness—despite sleeping 7 to 9 hours
  • Inability to sleep (insomnia)
  • Heart palpitations, “racing heart” or abnormally low heart rate
  • Difficulty breathing or shortness of breath
  • Thyroid or hormone imbalances
  • “Crazy” PMS or no period at all
  • Hanger before meals
  • Nutrient deficiencies
  • Frequent illness or colds
  • Dizzy when standing up from lying down
  • Feeling cold easily
  • Frequent urination or thirst—despite drinking water

—Just to name a few.

The symptoms of HPA-Dysfunction are diverse and nonspecific. Since nearly every cell in the body has receptors for cortisol, it can affect almost every tissue, organ, and body system, and stress impacts every individual differently (hence why there are SO MANY SIGNS of “adrenal fatigue”).

Adrenal Fatigue

The key separator in adrenal fatigue versus just “normal stress?”

The inability or difficulty to recover or feel “balanced” from the stress, leading to CHRONIC body imbalances (listed above)

 (In fact, for some people, this stressed-out state actually becomes their new “norm,” so much so sometimes that you even stop questioning if they can feel differently at all).

Scientifically speaking as well, “HPA Axis Dysfunction” is diagnosed—on paper—through a salivary or urinary hormone test. (The “DUTCH” Test is the gold standard).

Salivary and urinary cortisol—preferably both (as opposed to blood serum cortisol on a blood test) are able to measure the overall cortisol production and patterns of your body over the course of 24-hours in a day. In a person with “adrenal fatigue” or HPA-Axis Dysfunction, their cortisol levels (as well as potentially their sex hormone, DHEA levels and melatonin levels) will be out of the “normal range.”

Soooo…if your body CAN handle stress in life—what REALLY triggers your body to get so stressed out to the point of “adrenal fatigue” or imbalanced cortisol—not just normal stress?

Here are the 4 Top Causes of Adrenal Fatigue & What to Do About It if any of the above listed signs and symptoms sound familiar:

  1. Anxiety & Worry
    Relationship difficulties, finance worries, losing a job, public speaking, body image stress, feeling judged, low self-esteem, work stress, feeling out of control of a situation, fear, or any other event perceived as harmful and uncontrollable all fall within this category. This is perhaps the most common form of stress that most people think about when they hear the word “stress.”
  1. Artificial Light, iPhones & Coffee
    Your body runs on a 24-hour biological clock on a light-dark cycle. HPA axis is highly intertwined with mechanisms that control the circadian rhythm and vice versa. Sleep deprivation, high caffeine consumption, night shift work, blue light (artificial light) and screens (phones and computers) at night, travel, jet lag, and working in an office for long hours (with minimal daytime light exposure) all have a tremendous impact on the HPA axis. Exposure to circadian rhythm stressors at the wrong times, like at night, and lack of exposure to light at the right times, in the morning or during the day, messes with your cortisol balance, consequently impacting other aspects of your health (physiologically), such as not feeling completely rested, metabolic or hormone disruption, feeling “wired and tired” at night, poor digestive capacity, ability to get good quality sleep, ability to concentrate or focus, brain health, and more.
  1. Low Fat Diets, Low Carb Diets, High-Sugar, Under-eating & Over-eating
    Blood sugar imbalance” or glycemic dysregulation happens when your body is not nourished—completely. You may experience hanger, headaches or shakiness if you go only a few hours between meals, lose your appetite completely, or crave sugar or carbs frequently.Blood sugar imbalance is common in those who eat an unbalanced diet, go on crash diets, eat too much sugar (or processed foods) or those who are NOT digesting their food appropriately (ie. “leaky gut,” bacterial overgrowth or other gut dysfunction).For many, “blood sugar imbalance” goes unnoticed for years since lack of balance (in the diet or gut health) can become a norm for many. In fact, three in four Americans alone experience some sort of “gut issue” alone—from bloating and constipation, to gas after meals, skin breakouts, allergies, SIBO, fungal overgrowth and more—often leading to the inability to fully absorb the energy from nutrients they do consume. In addition, low fat, low-calorie or long-term low carb diets (without enough fat to support missing nutrients) can also lead to an under-nourished body and unstable blood sugar levels. Given that one of cortisol’s primary functions is to increase glucose (blood sugar and energy), it’s no surprise that hypoglycemia, or low blood sugar, is a powerful HPA Axis As for those who eat too much sugar (or other poor quality food sources—like processed foods, refined carbohydrates, bars, chips, pretzels, cookies etc.), blood sugar can go on a “roller coaster”—quickly increasing, and elevating cortisol—only to plummet one to three hours later, decreasing cortisol, which then demands MORE sugar or quick hits of nutrients in order to increase cortisol to “feel good” again. The beat goes on. Studies have shown that impaired glucose sensing in the hypothalamus and your body’s inability to balance blood sugar and have steady energy throughout the day is a key factor in metabolic problems related to HPA axis dysfunction
  1. Inflammation (Chronic Disease, Over-exercise, Long-term Medication Use)
    The final main driving cause of HPA-Axis Dysfunction is inflammation in the body. Any repeat stressor on the body tends to cause inflammation. Like picking a scab over and over and over again, eventually that wound will open (and ooze). And I am not just talking psychologically, but physiologically. You can be on a beach in Costa Rica with seemingly no care in the world, but still have tons of inflammation going on in your body. Chronic disease, an unhealthy gut, and other inflammatory-triggers and conditions (like surgery or an acute injury, antibiotic or NSAID use, overexercise, eating foods you are intolerant to, etc.) are all sources that spur on inflammation, and consequently HPA-Axis Dysfunction.


So you recognize you’re not feeling on your A-Game…now what?

Addressing stress—physiologically and psychological— is the key to “reversing” adrenal fatigue, and depending on the length of stress, your specific cortisol picture (too high or too low) and symptoms, healing will look differently.

Adrenal Fatigue Recovery

That said, you can recover and do not have to feel how you do if you are experiencing imbalances.

In clinical practice, here is what the steps of healing look like.

  1. Assess Your Own Stress.
    What are the top stressors in your life right now, and what stressors have you dealt with in your past? Surgeries? Medications? Light exposure? A job you hate? Food intolerances? Gut issues? Make a list of both psychological and physiological factors that may be contributing to your current state of stress.
  1. Test Don’t Guess.
    Many people read about “adrenal fatigue” on Google and immediately turn to self-treating—buying supplements and tea labeled “adrenal support” at Whole Foods, downloading the Headspace meditation app, and diffusing lavender in the air However, without understanding a full picture of the cortisol imbalance in your body (if at all), you may be under treating or over treating. Cortisol may be high or low, melatonin may be suppressed or perfectly normal, estrogen may be nonexistent or extremely elevated. In addition, cortisol imbalance may be triggered by the gut, the hypothalamus or your thyroid, or a mix of all three. The problem is, if you treat your “issue” inappropriately you risk not getting to the “root” or potentially making the problem worse. Connect with me at Thrive  or another practitioner who is trained and familiar in hormone testing—specifically stress hormones (cortisol)—and HPA Axis Dysfunction. The DUTCH test  is the gold standard and a practitioner can help order and interpret labs. In addition, beyond hormone testing, gut testing and routine lab work may also be warranted, considering the connection between gut health and stress.
  1. Address Stress.
    Stress management goes beyond meditation. Eliminating stress is the number one focus of HPA-Axis Dysfunction. True, there are supplements as well that may be part of an adrenal healing protocol, but you cannot supplement your way out of adrenal fatigue or HPA-Axis Dysfunction. How to eliminate stress?Some basics to start:Nutrition
    Balance your meals with protein, healthy fats and moderate carbs. No extremes. Protein, particularly in the morning, has a balancing effect on blood sugar. Avoid foods with fillers, sweeteners and unknown ingredients. For a time, avoid caffeine and alcohol. Prioritize clean filtered water (Tip: Add a pinch of sea salt to 12 to 16 ounces of water in the morning. Sea salt is a natural electrolyte to balance sodium levels). Also don’t neglect mindful eating (chewing your food well, slowing down at meal times, not eating on the go or while watching TV, etc.). Mindfulness is a game changing practice your body appreciates.Circadian Reset
    Eliminate blue light exposure at night (blue-blocking glasses, nightshift apps on your phone), get back to nature (aim for 30-60 minutes at least of fresh air), eat at regular intervals, and guard sleep…Sleep
    Speaking of sleep is essential to just about every type of “wellness” protocol, but it is particularly essential for HPA-Axis Dysfunction recovery. Prioritize 7 to 9 hours each night.
  1. Move
    Overtraining is a common cause of HPA-Dysfunction. Common signs of overtraining include difficulty recovering from workouts, increased gut issues or loss of appetite, a plateau or decrease in performance, increased body fat despite regular exercise and “eating clean,” poor sleep, restlessness, anxiety, fatigue, muscle or joint pain, suppressed immune system, and low mood. The best exercise? In the immediate recovery period, opt for lower intensity exercise such as walking, cycling (not cranking up the notch on your spin bike), strength training, swimming, or yoga over high-intensity activities like CrossFit WODs, Orange Theory workouts or straight-up cardio training.Just Say No
    What’s filling your life and what’s draining you? Take a thoughtful inventory of what’s crowding your space. Cut out the things on your plate that are weighing you down.Relax
    As cheesy or overrated as it sounds, taking time out to settle your mind and integrate mindful activities through mental and physical (intentional) relaxation. Prayer, journaling, meditation, biofeedback and yoga are just some ways people actively seek to “relax” more. Although it will probably be “awkward” at first, by starting small and prioritizing relaxation (even 5 minutes in the morning) make a difference.
  1. Supplement Savvy
    As mentioned, testing and not guessing helps prevent over-treating or under-treating with supplements. Turmeric is a natural spice that is anti-inflammatory, and lavender and other essential oils can also provide natural stress-relieving supports to compliment lifestyle, nutrition and supplemental support. Two basic HPA-Balance supports I do recommend for most individuals as a foundation to their customized HPA-Axis treatment is AdrenaCalm by Apex Energetics   and HPA-Balance by Vital Plan.

The bottom line?

It is vital to understand why and what is driving your stress in order to recover from “adrenal fatigue.” Addressing stress is the number one treatment for recovering from HPA-Axis Dysfunction and…you were made to feel good (like really good).

2 thoughts on “4 Top Causes of Adrenal Fatigue & What to Do About It

  1. Everyone keeps on mentioning SLEEP but how can we sleep when our whole system is weak because of the HPA axis dysfunction?? It’s easy to say “sleep more” when we simply cannot, no matter what we do. Why this is rarely addressed is beyond me and it’s extremely frustrating.

    1. Great point! Addressing the systems to HELP you sleep IS crucial (HPA Axis) through a HPA-Axis Dysfunction healing protocol is essential to helping support your body’s ability to sleep. I’d be happy to help you figure out how to do that if you need some guidance! Head over to https://drlauryn.com/contact and sleep is yours for the taking!

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