Dr. Will Cole, Guest
Thyroid Nation

Adrenal Fatigue And HPA Axis Dysfunction

We are a society of sleepiness, running on fumes and caffeine, craving sugary foods, and suffering from debilitating exhaustion. Today, chronic fatigue affects more than 1 million people in the United States—and that’s not even counting all the mildly to moderately fatigued.

Chronic fatigue syndrome is multifaceted, but one common aspect of the condition is something called adrenal fatigue.

The adrenal glands, which sit on top of your kidneys like little kidney baseball caps, release several important hormones, one of which is cortisol. You’ve probably heard about cortisol before since it’s your major stress hormone. Cortisol is supposed to be higher in the morning when you wake up and slowly go down throughout the day so that you can sleep well. It’s not necessarily a bad guy—it actually helps regulate your blood sugar and pressure—but you want cortisol to be in balance. Not too high and not too low.

Adrenal fatigue is not really an adrenal problem but a brain problem. Typically, adrenal fatigue is when the brain-adrenal (HPA) axis isn’t working so well. This HPA axis dysfunction can cause low cortisol when it should be high and high cortisol when it should be low, and everything in between. That is not fun.

If you have adrenal fatigue, here’s what you might experience:

  • You’re slow to start in the morning.
  • You crave salty or sugary foods.
  • You have a low libido.
  • You’re fatigued in the afternoon.
  • You get a “second wind” in the evening.
  • You can’t stay asleep.
  • You experience dizziness when standing up quickly.
  • You get afternoon headaches.
  • You have blood sugar issues.
  • You have chronic inflammation.
  • Your nails are weak.
  • You’re often moody.
  • You have difficulty losing weight.

As a functional medicine practitioner, I’m normally the one guiding people out of their health problems. So when I saw the symptoms of adrenal fatigue creeping into my own life, I knew I had to start practicing what I teach.

If you’d also like to heal your adrenal fatigue, here are the steps I took to rehab the condition. I also recommend them to many of my patients:

1. I Ran Some Labs.

In addition to conventional blood labs, I wanted to run a few extra labs to find out for sure what was going on, including:

  • Adrenal fatigue labs: This lab involves spitting into several vials throughout the day. It’s a lot of spit, but it can also give you a lot of information about your brain-adrenal function. I learned I did have adrenal (HPA) dysfunction.
  • Microbiome labs: The microbiome refers to the trillions of bacteria in your gut. You may be thinking, “Why would you look in the gut when considering adrenal fatigue?” Our gut health is the foundation of our total health, especially brain and hormonal health. Dealing with underlying leaky gut syndrome, candida overgrowth, and small intestinal bacterial overgrowth is essential for recovering from adrenal fatigue.
  • Methylation labs: Methylation is a massive biochemical superhighway that happens 1 billion times every second in the human body. It makes a healthy brain, gut, hormones, and detox pathways and protects your DNA. All super important stuff. Genes that make methylation happen can be mutated in some of us. This decreases methylation and can cause a variety of health issues. I had multiple methylation gene mutations, one of which is the MTHFR gene.

I believe we all need different labs to discover root health issues, based on our unique health history. Consider a free health evaluation to get a functional medicine perspective on your case.


2. I Jump-Started My Hormone Rehab With A 90-Day Reset Diet.

Food is medicine. I always ate healthy, other than my favorite “healthy junk foods” of gluten-free pizza and stevia soda. But I knew that if I was going to rehab my adrenal fatigue, I had to take my food medicine plan to the next level. I had to make sure my diet was on point for hormone health. Here’s the 90-day food plan I used to improve my sleep and energy.

3. I Ate Nutrient-Dense Proteins.


Oysters are packed with zinc! The trace mineral ratio between copper and zinc can help with healthy neurotransmitter function and adaptation to stress. Increased copper and decreased zinc has been shown to contribute to brain stress and anxiety. This superfood of the sea is a great way to balance the proper trace mineral ratio and your stress levels.

Organic turkey

You know that food coma people get into after Thanksgiving dinner? It’s actually from the calming amino acid tryptophan in the turkey. Tryptophan is a precursor to the neurotransmitter serotonin, which helps you feel calm and deal with anxiety.

Grass-fed organ meats

Organ meats like liver are some of the best sources of nutrients needed to beat fatigue, like zinc and vitamin D. They also contain copious amounts of choline and other B vitamins needed for methylation.

4. I Ate More Green Superfoods.

Leafy greens

Plant foods like Swiss chard and spinach are rich in magnesium, the original “chill pill,” which helps to regulate the brain-adrenal axis.


This sulfur-rich vegetable also contains the beneficial B vitamin folate. Low levels of folate are linked to neurotransmitter impairment, which can lead to brain-hormonal problems.

5. I Ate Healthy Fats Every Day.


Avocados contain beneficial B vitamins and monounsaturated fats that are needed for neurotransmitter and brain health. This fatty super fruit also contains potassium, which helps to naturally lower blood pressure.

Full-fat kefir

Bacterial imbalances in your gut can contribute to brain problems. Kefir is rich in beneficial bacteria for your microbiome and also has fat soluble vitamins A, D, and K2, which are important for brain health.

Coconut oil

I love using coconut oil, which offers good fats like medium-chain triglycerides (MCTs) that can help with brain function. I cook with coconut oil, put it in smoothies, or simply eat it off a spoon.

Wild-caught fish

Inflammation is an important factor when it comes to brain and hormonal health. Omega-rich foods like Alaskan salmon can help decrease inflammation.


6. I Sipped On Relaxing Tea.

Camomile tea

This soothing, mild tea has been shown to help decrease anxiety, depression, and stress symptoms in just a few weeks.

Rooibos tea

African red bush, or Rooibos, can have a balancing effect on cortisol.

7. I Used Natural Medicines.

Functional medicine focuses on finding the root reason why we have health problems in the first place. We want to support the underlying mechanisms that aren’t working so well. Because so much of adrenal fatigue is really brain-based, most of the natural medicines I used focused on supporting optimal brain health and its response to stress.

I used blends of adaptogenic herbs like ashwagandha, eleuthero ginseng, holy basil and rhodiola rosea to give my adrenal axis some TLC. I also incorporated phosphatidylserine supplements into my routine. (Of course, consult your doctor first before implementing any herbs or supplements.)

8. I Upped My Magnesium Intake.

In addition to eating magnesium-rich foods, supplementing with magnesium can take its benefits to the next level. It helps support the adrenal glands, relaxes stressed muscles and nerves, and promotes quality sleep. I am a fan of magnesium threonate, which studies suggest can be beneficial to the brain. I also put magnesium oil on my skin.

9. I Brought My Inflammation Levels Down.

I love turmeric! Curcumin, a compound in turmeric with antioxidant properties, has a neuroprotective quality and helps enhance your mood. In a randomized controlled trial, it was suggested to be an effective option for depression, which can be common with adrenal fatigue.

10. I Changed My Sleep Habits.

If I was going to rehab my adrenals, I needed to make sure I wasn’t staying up too late. That’s difficult when you work all day, get home late, and just want time to unwind. But we all need to allow our brain and adrenals time to recuperate overnight.

I now try to avoid caffeine in the afternoon. This is difficult, as I am a self-admitted tea addict, but I opt for the caffeine-free camomile or rooibos instead.

I also promote quality sleep by turning off the TV, computer, and smartphone a few hours before bed (they can overstimulate the brain, block melatonin production, and hurt your quality of sleep). And I often eat an ounce or two of clean protein like organic turkey and 2 tablespoons of coconut oil before bed to balance out my blood sugar throughout the night.

11. I Learned Stress Management Techniques.

Stress can have many devastating effects on health. You can eat perfectly, but if you don’t learn to manage stress, it won’t mean much in the end.

So during my healing journey, I started practicing mindfulness meditation and other strategies to bring mindfulness into my day. Even just taking some time throughout the day to become aware of your breath is a simple way to defuse stress levels and calm your brain-adrenal axis. I’m also a big fan of listening to Eckhart Tolle audiobooks when I’m in the car.

12. I Began Practicing Yoga Regularly. 

I wanted to bring practices of alertness and stillness into my life, and yoga is one of my favorite ways to do that. I recommend the awesome video courses from my mindbodygreen siblings Lauren Imparato and Tara Stiles and Michael Taylor to bring yoga right into your home.

13. I Spent More Time Outdoors. 

Because I have a job that’s indoors, I need to make it a point to get outside. I believe there has to be something coded in our DNA, a primal blueprint that finds affinity with getting in the sun and breathing fresh air. I try to practice earthing, or walking barefoot outside, as much I can to help de-stress.

14. I Made Sure My Vitamin D Levels Were On Point.

Spending more time outside in the sun also helps with your levels of vitamin D, which is responsible for regulating over 200 genetic pathways. I recommend an optimal range of around 60 to 80 ng/ml.

15. I Learned To Say “No”. 

This one is still hard for me—I don’t want to disappoint anybody and there is always more work to be done. But at a certain point, I needed to create some space in my life, space to just refuel and spend time with my family.

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About the Author

dr-will-cole-functional-medicine-expert-and-practionerDr. William Cole, DC, graduated from Southern California University of Health Sciences in Los Angeles, California. He has his post doctorate education and training in Functional Medicine and Clinical Nutrition. Dr. Cole consults in the Pittsburgh area and phone or webcam consultations for people around the world. He specializes in clinically investigating underlying factors and customizing health programs for chronic conditions such as thyroid issues, autoimmune, hormonal dysfunctions, digestive disorders, diabetes, heart disease and fibromyalgia. Visit Drwillcole.com for more information and subscribe to his free monthly Future Health Newsletter to stay plugged in with healthy tips and recipes. This article originally appeared on Mind Body Green.

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Questions or anything to add about healing adrenal fatigue? We want your thoughts, please. You might just help someone else in need.