Anyone heard of adrenal fatigue? Nope, me neither until I was introduced to the concept of ‘living in a permanent state of hyper-vigilance’ by a therapist I used to visit in Melbourne. I know, what does that even mean? Well, this concept can be more easily explained as an underlying but permanent level of anxiety due to chronic stress and, whilst you don’t necessarily have to display outward signs of anxiety, if you have an emotional, physical or psychological stress; if it’s a single, intense stress; repeated or chronic stress, the effect on your adrenal glands will likely be the same – adrenal fatigue.


In response to stress your adrenal glands release adrenalin and the hormones DHEA and cortisol, which regulate energy production and storage, immune function, heart rate, muscle tone, and other processes that enable you to cope with the stress. Adrenal fatigue is a collection of symptoms that occur when the adrenal glands function below the necessary level and are unable to maintain the equilibrium within your body. This type of fatigue is not alleviated by a good night’s kip and, whilst you might look and act relatively normal with adrenal fatigue and may not have any obvious signs of a physical illness, you may have a tendency toward a general sense of unwellness, tiredness or “feeling flat”. Those who experience adrenal fatigue often have to use stimulants such as coffee or high sugar foods in order to keep them going throughout the day and, may also experience great trouble falling or staying asleep.

Adrenal fatigue can initiate changes in your carbohydrate, protein and fat metabolism, fluid and electrolyte balance, heart and cardiovascular system, and even sex drive. In some instances, where the activity of the adrenal glands is so diminished, the sufferer may even have difficulty getting out of bed for more than a few hours a day.


Some signs of adrenal fatigue can be…

  • Tiredness for no reason

  • Trouble sleeping and difficulty in getting out of bed in the morning despite that early night

  • Feeling rundown or overwhelmed

  • Salt or sugar cravings

  • Mental fogginess

  • Depression

  • Difficulty recovering from stress or illness

  • Feeling more awake and alert after 6pm than you do throughout the rest of the day

Unfortunately, adrenal fatigue is not formally recognised by your common-or-garden-variety GP, so once you have eliminated any other possible causes for your fatigue (there are many other conditions that will have similar symptoms), you will more than likely need to seek advice from a nutritional therapist or alternative medicine practitioner in order to establish a formal diagnosis and commence the appropriate treatment.


Since arriving back in the UK, I have kept regular appointments with qualified nutritional therapist Pauline Thomas aka Eat Well Pixie. Having completed an extensive questionnaire where I detailed absolutely everything about my health and well-being and, after addressing both my iron and zinc deficiencies, which can both contribute to extreme fatigue, Pauline suggested that I take a ‘saliva’ test to determine whether I was suffering from adrenal fatigue. This test is supplied to your home and the samples then sent off for testing in an independent clinical laboratory called Genova Diagnostics Europe (or Healthscope Pathology in Australia), who then send the results on to your practitioner for translation into plain English 🙂

In separate test tubes, I collected saliva samples (nice) at four points during the day, then sent them off for testing. These samples were measured for levels of cortisol and DHEA and an evaluation provided of how cortisol levels differ throughout the day – cortisol levels typically peak shortly after rising and are at their lowest after the onset of sleep.
Cortisol is involved in many important functions in your body, including the metabolism and utilisation of proteins, carbohydrates and fats, your body’s response to physiological or psychological stress, and the control of inflammation and proper blood sugar levels. Cortisol also helps maintain proper blood pressure, normal nerve and brain activity and normal heart and immune function.

DHEA also plays a role in the metabolism of protein, carbohydrates and fats, and works with cortisol to help maintain proper blood sugar levels. DHEA helps regulate body weight, blood pressure and immune function, and is used by the body to make various hormones. Too much or too little of cortisol or DHEA can lead to illness, and it is important that these two hormones be in balance with each other.

  • Sample 1 (Post awakening): My cortisol level was within the reference range. Cortisol should be at a peak shortly after awakening and therefore morning cortisol may be a good indicator of peak adrenal gland function, i.e how well the adrenals are working.

  • Sample 2 (Mid-day): My cortisol level was within the reference range, but at the lower end. Mid-day cortisol levels may be a good indication as to how the adrenal glands adapt over time, since they represent the adrenal glands’ response to the demands of the first few hours of the day. Whilst the result was within reference range it was at the low end and this could indicate long term stress concerns. This was analysed in conjunction with my Adrenal Monitor Questionnaire and, alongside the symptoms I had described indicated a level of adrenal fatigue.

  • Sample 3 (Late afternoon): My cortisol level was within the reference range. Afternoon cortisol levels may be a good indication of the adrenal glands’ ability to help regulate blood sugar, since they represent a sample taken after lunch. My afternoon levels were within the reference range suggesting normal adrenal function in the area of balancing blood sugar.

  • Sample 4 (Late evening/before bed): My cortisol level was within the reference range. Late-night cortisol levels may be a good indication of baseline adrenal gland function since they typically represent the lowest level during the day. Normal late-night cortisol levels suggest normal adrenal function with regard to baseline circadian activity.

DHEA was within the reference range and my ratio of DHEA to cortisol was normal. This ratio indicated a relative balance of the adrenal output of hormones and cortisol indicating a balance in the body, at the time the test was taken.

So, whilst the overall results established normal adrenal function, sample 2 did indicate a level of adrenal fatigue that had been on-going for some time.


From a dietary perspective…

Timing your meals and how much you eat can help regulate cortisol and its natural cycle. Eating larger meals earlier in the day naturally helps support cortisol levels, while eating smaller, lighter meals at the end of the day helps maintain hormonal balance. So, less sugar; more lean protein; consume only healthy fats; eat organic wherever possible; avoid preservatives; eat brightly coloured veg; drink matcha or regular green tea (but best before 3pm); have a healthy snack both mid-morning and between 2-3pm to offset the cortisol dip; and a small healthy snack before bed.


With the expert guidance of a qualified health practitioner, supplementation with vitamin C, E and B vitamins may help to regulate stress hormones; and calcium, zinc, manganese, magnesium, selenium and iodine have a calming effect on the body.

Lifestyle changes…

Even if you’re a gym junkie, try not to over-exercise (music to my ears); get more sleep and look at ways of improving your sleeping environment as covered in my article about Sleep Debt; an Epsom Salts bath is a great relaxant before bed; practise mindfulness techniques like these at; and try to eliminate as much stress as possible from your life (yes, I know, easier said than done :-0)

Aaaand relax…..