by Jenny Lelwica Buttaccio
Posted 9/4/20

See if these scenarios strike a chord with you:

• Your morning alarm goes off, but you can’t muster the physical energy to get out of bed.
• You used to handle stress well, but these days, even the slightest challenge leaves you dragging in the days or even weeks that follow.
• Though you struggle to make it through the day, when night time comes, you get a second wind and find yourself wide-eyed until the early morning hours.

If any or all of these sound familiar, you could be contending with a condition known as adrenal fatigue. The adrenal glands, two triangle-shaped glands located on the top of each kidney, are responsible for regulating your metabolism, immune system, blood pressure, stress response, and more. They do this by producing hormones like stress hormones (cortisol, adrenaline) and sex hormones (testosterone, estrogen).

Cortisol levels in particular are a harbinger of adrenal health. When life is calm, cortisol secretion follows a gentle circadian rhythm: It starts rising at four or five in the morning to wake you up and prepare the body for the day. As the day reaches its end, cortisol levels gradually decline and remain low through the night, when the body recovers from the stress of the day. Lowered cortisol allows the body to focus on maintenance functions, immune functions, digestion, and healing.

“The big thing that really perpetuates adrenal fatigue is stress,” says Dr. Bill Rawls, Medical Director of RawlsMD and Vital Plan. “We call the adrenal glands ‘stress glands,’ but they’re more about mobilizing resources to various parts of the body.” And when the glands are stressed, their ability to support you during stressful times wanes, and you’ll likely begin to experience a progression of adrenal dysfunction.

As a general guideline, adrenal dysfunction occurs in three primary stages:

Stage 1: Adrenal Overdrive

People in this stage tend to thrive on adrenaline and push themselves to their limits (the “Type A Personality”). Cortisol levels remain relatively stable, but early warning signs emerge — things like constantly feeling wired, an ongoing need for caffeine to stay energized, high blood pressure, or a rapid heart rate — as the body continues to be driven harder.

Stage 2: Flipped Adrenals

If stage one isn’t corrected, adrenal fatigue worsens. It starts to take its toll on the body, and you begin to pump out both adrenaline and cortisol to combat signs of exhaustion. In this stage, the body’s natural rhythm begins to flip. Instead of feeling energized throughout the day, you feel worn out. In the evening, rather than feeling drowsy, an energy burst of adrenaline and cortisol kicks in. As you try to go to sleep, you feel wired, restless, and agitated. Your usual vitality and zest fade, and it’s a chore to get out of bed in the mornings.

Adrenal Burnout

Also known as severe adrenal fatigue, your cortisol levels are chronically low, giving rise to adrenal burnout or flat adrenal function. Though adrenaline used to get you through the day, now you’re exhausted, drained, and unable to keep up with normal energy demands. People in this stage of dysfunction may experience a total collapse, and rest alone isn’t enough to heal a depleted body. As the body continues to break down, the immune system becomes chronically disrupted and chronic illness ensues. You feel completely depleted and may not even be able to get out of bed.

Although the various stages of adrenal fatigue seem pretty overwhelming, the good news is that with patience, gentle care, and persistence, your energy levels and quality of life can dramatically improve, even when you’ve reached severe adrenal fatigue.

What Happens When Severe Adrenal Fatigue Hits

First, let’s look at what happens when all is working as it should, and the adrenal glands’ flight-or-fight response prepares you for occasional confrontation and allows you to take action. For instance, if a dog dashes out in front of your car while driving, a rush of adrenaline and cortisol will flow through you, increasing your heart rate, honing your focus, and rousing your reflexes.

At the same time, your body prioritizes resources to avoid a collision, and other systems, such as digestion, sleep, and immune function, temporarily take a back seat. If you successfully maneuver through the situation, your body begins to relax once the threat has passed.

While incredibly unnerving, a dog bolting out in front of a car is an example of a short-term threat, and likely one that happens infrequently. However, most of us live in a state of constant threats.

“We’re bombarded with negative stimulation around the clock,” says Dr. Rawls. “There’s incessant conflict on the news, distressing information on social media, and challenging circumstances in the workplace.” Life conditions like these keep you pumping out adrenaline and cortisol 24/7.

Eventually, the continual barrage of stress leads to burnout — a debilitating state where cortisol can’t keep up, and adrenaline takes over. And when you add a chronic illness like Lyme disease to the mix, normal restorative processes such as sleep, cell and tissue repair, and immune system regulation are already functioning suboptimally. Therefore, you likely feel like you’re running on fumes, creating ideal conditions for severe adrenal fatigue and indescribable exhaustion.

Unfortunately, the usual recommended interventions for adrenal fatigue — prescription cortisol (Cortef) to counter chronically-low levels; adrenal extracts (a supplement made from the adrenal glands of pigs, cows, or sheep); or energizing herbs — can actually make you feel worse. These interventions tend to be stimulating in people with severe adrenal fatigue. Think of it like this: If your body is breaking down, and you’re already running on adrenaline, an extra dose of stimulation just might be the thing that tips you over the edge.

Since every person is different, even mild supplements aimed at boosting energy may cause some individuals with a serious case of adrenal burnout to feel hyper and wired instead of feeling calm and energetic. It’s a frustrating consequence of a nervous system that’s on high alert all the time.

So is there a way to achieve progress in re-energizing your adrenal glands without worsening your symptoms? If you’re experiencing stage 1 or 2 adrenal fatigue, you may be able to tackle it with some straightforward lifestyle changes like minimizing stress and getting eight hours of sleep each night. However, if you have stage 3 adrenal fatigue, addressing it can be a bit tricky.

Here, we’ll take a look at gentle solutions to restore and nourish your adrenals from severe adrenal fatigue and support your recovery from the inside out. A low and slow approach is integral to avoiding a setback, and if necessary, paving the way for more powerful solutions to be added to your repertoire.

6 Natural Solutions for Severe Adrenal Fatigue

The key to strengthening and rejuvenating the adrenal glands is to nurture the body from a holistic perspective, says Dr. Rawls. All the systems of the body are interconnected — right down to each individual cell. If you resuscitate the cells by providing them with adequate nutrients (e.g. water, oxygen, vitamins, and minerals, to name a few), you’ll automatically improve adrenal function.

Beyond eating a nourishing diet, additional solutions don’t have to be time-consuming or cost-prohibitive to encourage wellness. Here’s what Dr. Rawls recommends.

1. Seek to Restore Your Sleep Rhythm.

Sleep is the very thing you need to assist with normalizing adrenal function, but sadly, it’s the aspect of health that can feel impossible to attain. “Restoring sleep is essential,” says Dr. Rawls, so it’s imperative that you make it a top priority to recover from adrenal fatigue.

To get your sleep rhythms back on track, turn off your electronics by 9 PM (8 PM if you have an especially difficult time winding down at night). For one, anything electronic — televisions, computers, cell phones, etc. — tends to be more arousing than calming, and your adrenals need less stimulation, not more. What’s more, reducing your exposure to artificial light in the evening hours will promote the release of melatonin, the body’s sleep-inducing hormone.

Also, make sure you’re in bed by 10:30 PM or 11:00 PM at the latest to avoid the burst of adrenaline known as “the second wind,” which can prevent you from falling asleep for several more hours. If possible, try to sleep in until 8:00 AM so that your morning cortisol levels have a chance to rise before you go about your day. Although it’s never easy to adjust your schedule, seeking to restore your sleep rhythm allows time for your body’s rest and repair functions and reinforces the sleep-wake cycle.

2. Drink Nourishing Bone Broth.

Your diet plays a key role in whether you feel energized or drained during the day, adrenal fatigue or no. High-carbohydrate and refined foods like those in the standard American diet — pasta, white bread, chips, crackers, sweets, and the like — are devoid of nutrients and do next to nothing to revitalize a depleted system. One simple way to get crucial, fatigue-fighting nutrients in your diet and fuel exhausted adrenal glands is by drinking bone broth.

Filled with collagen, amino acids, gelatin, and an array of vitamins and minerals (calcium, phosphorus, magnesium, and zinc, to name a few), bone broth is nutritious and easily-digestible. Plus, the gelatin in it helps heal and soothe an irritated digestive tract, a common symptom of those with chronic Lyme. Bone broth can be made by using the following steps:

• Place the bones of your choice, usually chicken or beef, in a large Crock-Pot.
• Add your favorite vegetables like onions, carrots, and celery, along with fresh spices.
• Cover the contents with water.
• Slow cook on low for up to 8 hours.

Aim for drinking 2 cups of bone broth a day to replenish your body. Note that some individuals who require a low-histamine diet (like those with mast cell activation syndrome (MCAS) may have trouble with the high histamine levels found in bone broth. If this is the case for you, a meat stock cooked in a pot for 2 to 3 hours may be a better alternative to keep histamines to a minimum.

Finally, to round out a healthful diet in conjunction with bone broth, be sure to reach for foods like vegetables, lean meat (fish and organic poultry), low-sugar fruits, nuts, seeds, and seaweed.

3. Boost Your Intake of Sea Salt.

The adrenal glands secrete aldosterone, a hormone that assists in maintaining the salt and water balance in the body. However, when dealing with months and even years of stress and chronic illness, your adrenals may have difficulty regulating electrolytes like sodium and fluid balance. Thus, you may experience symptoms like light-headedness upon standing, low blood pressure, and postural orthostatic tachycardia syndrome (POTS), an array of symptoms that impact the body’s ability to adequately circulate blood.

One strategy to maintain adequate fluid levels in the body is to consume more sea salt, which also contains trace minerals, to increase blood volume. To boost your intake of this mineral, liberally salt your food. You can also dissolve ¼ to 1 teaspoon of sea salt into a glass of water and sip on it throughout the day.

4. Try Calming Herbs.

For some people, typical herbal recommendations for adaptogens like rhodiola or eleuthero — herbs that are known for their anti-stress qualities and ability to invigorate different systems and organs throughout the body — may be too stimulating, says Dr. Rawls, at least when adrenal fatigue is severe.

Instead, reach for herbs that have a calming effect on the nervous system. Dr. Rawls’ top choices include:

• L-theanine: An amino acid found in green tea, l-theanine induces calmness, supports a positive mood, improves mental focus, and promotes sleep — all without the hangover feeling or next-day sedation that medications (like sleeping pills) may cause.
• Licorice root: Licorice restores and supports the adrenal glands by maintaining normal blood pressure and cortisol rhythms. Licorice also helps to restore the immune system and contains anti-viral properties.
• Ashwagandha: Native to India and Africa, ashwagandha assists in balancing the hypothalamic-pituitary-adrenal axis (HPA axis) in the brain, the control center that governs your stress response and regulates hormones. The herb also contains antioxidant, anti-inflammatory, antimicrobial, and immune-enhancing qualities.

As adrenal fatigue improves, you may begin to tolerate additional herbal therapies. Herbs like cordyceps and reishi mushroom can be useful to support adrenal health while balancing immune system functions. Additionally, you might find herbs such as rhodiola and eleuthero become a source of calm energy for you, rather than adding to the stimulation, as your healing progresses.

5. Be Mindful of Your Adrenaline Levels.

“To recover, you must remove the stress factors from your life,” advises Dr. Rawls, especially if you’re dealing with burnout and life-altering exhaustion, and relying on adrenaline to get you through the day. To combat excess adrenaline and bring awareness to the stress and tension your body might be holding on to, Dr. Rawls recommends “zeroing out” your adrenaline levels 2-3 times a day.

The process is quite simple: Set aside 10-15 minutes a few times a day to focus on deep breathing exercises. If possible, try to find a quiet place free of disruptions, sit or lie down in a comfortable position, and breathe your way to a more relaxed state. “Doing this isn’t hard — making the time for it is the biggest obstacle,” says Dr. Rawls.

6. Increase Blood Flow to the Adrenals.

Improving blood flow to the adrenal glands is vital to usher in nutrients, assist the body in purging cellular toxins, and enhance cellular functions. Although exercise is an effective tool for enhancing circulation, overdoing the intensity of any physical activity is a legitimate concern when you’re trying to avoid a crash.

The key, then, is to concentrate on exercises that are restorative to the body, as opposed to ones that leave you feeling more drained. Look for activities that alleviate pain, ease muscle tension, allow for low-impact movement, and can be modified to fit your daily energy levels. Some examples include:

• Walking
• Pilates
• Qigong (a favorite activity of Dr. Rawls)
• Restorative yoga
• Tai chi

As you start to rebuild your energy reserves, and the fatigue begins to abate, you’ll often find that you can progress to more intense workouts without experiencing setbacks.

As for how long it takes to recover from adrenal fatigue? “It’s going to take a while to rebound,” says Dr. Rawls. “Part of it is how much effort you’re willing to put forth and how long you’ve been feeling poorly. The body has the extraordinary ability to heal itself, but it takes patience, time, and dedication.”

The good news, however, is that any step you take toward healing adrenal fatigue will benefit your long-term recovery from chronic Lyme disease and other chronic illnesses, too. So, practice patience, put yourself and your health first, and take it one step and one day at a time.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.