Episode 20: The Many Causes of Adrenal Fatigue (Part 1)

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Thanks for joining us for episode 20 of The Ancestral RDs podcast! If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode!

Today we’re going to be talking about all the different underlying causes of adrenal fatigue syndrome, which is also referred to as HPA axis dysregulation in the medical community. Last time we primarily focused on the way that a strict Paleo diet and lifestyle could actually be counter productive, and today we’re going to dive a little bit deeper into the vast array of different potential causes of adrenal fatigue

Remember, if you’d like to submit a question for our podcast, or suggest a guest that we should host, CLICK HERE.

Here’s what Laura and Kelsey will be discussing in this episode:

  1. Update on how the Paleo Rehab: Adrenal Fatigue Beta program is going. (It’s great!)
  2. How your diet may be causing adrenal fatigue.
  3. The lifestyle habits that harm your adrenals.
  4. The two different types of stress that can lead to HPA axis dysregulation.

Links Discussed:


Laura: Hey everyone. Welcome to episode 20 of The Ancestral RDs podcast. I’m Laura and with me as always is Kelsey.

Kelsey: Hey everybody.

Laura: Today we are going to be talking about all of the different underlying causes of adrenal fatigue syndrome, which as we mentioned last time is also referred to as HPA axis dysregulation. Last time we primarily focused on the way that a strict Paleo diet and lifestyle can actually be counterproductive to adrenal health. Today we are going to dive a little bit deeper into the vast array of different potential causes of adrenal fatigue.

You may be wondering why we’re going so hardcore into adrenal fatigue. If you haven’t noticed from our Facebook, and, emails and all of that, we are putting together an adrenal fatigue program. Right now we’re in the beta test phase of it. We have about 30 participants that are going through the program, and giving us feedback, and helping us refine it so that it is the best program on the market for helping people heal from adrenal fatigue.

It’s funny, every time we do a podcast, or an article, or anything, we start realizing oh my gosh, we could put all this information into the program. I feel like it’s going to be a lot bigger and more awesome that it was even when we first designed it and launched it for the beta. What do you think, Kelsey?

Kelsey: Yeah, I think so too. It’s really great because we’re in week two of the beta program right now and we’re getting a lot of great feedback from our participants. I think it’s going really well already and it’s going to get even better with all this extra information that we’re going to include as well.

Laura: Yeah, I think what’s really interesting to me just interacting with the people in the Facebook group is that it seems like everyone kind of has their own reason for adrenal fatigue. Some people going through the diet module, they’ve been having all these really awesome realizations about their diet not being appropriate and they’re realizing maybe they’re not eating enough, maybe they’re not eating the right types of foods. So they’re already feeling better just making these little diet tweaks.

And then we have other people who they go through the diet module and then they say okay, actually I am eating this way, so maybe diet is not a problem. Sometimes people can get a little frustrated when they go through some kind of training and say well, I’m already doing all this, so that’s not helpful. But in my opinion, and this is something that I see with a lot of clients, sometimes knowing that you’re doing everything right is actually really helpful because it can take some of the stress off of you feeling like you’re not doing what you’re supposing to be doing.

Kelsey: Yeah. I think that’s huge. Often when I work with clients, even if they’re doing things right already and I just confirm like wow, you’ve been really been doing well with this part of it just when they’re coming in for their first consult with me. It’s great to hear the relief in their voice. It’s just like oh Thank God! I was worried I wasn’t doing this right and it’s just so great to hear someone, a professional, tell me that I’m actually doing the right thing and that I’m on the right track.

Laura: Yeah, and it’s tough because adrenal fatigue is one of those conditions that is so multi factorial that you might be doing the diet side of things perfectly, and like we said before, sometimes you get frustrated because well if I’m eating the perfect diet for adrenal fatigue, why do I still have adrenal fatigue? But then you don’t even recognize that you’re missing two other components of your healing protocol. Focusing so much on the diet when your diet is already pretty good is counterproductive.

I’ll be excited to see what happens with the beta testers once they get through the whole program because I do really think that there’s going to be kind of one of these something for everyone type effects of the program because we’re covering so many different factors. It’s cool, and like we said, if you just get confirmation that you’re doing the right thing, it can relieve so much stress off your plate that that in of itself can helpful for adrenal fatigue.

Kelsey: Yeah.

Laura: I’m excited.

Kelsey: Me too. It’s been so fun to go through the beta. I don’t know about you Laura, but for me we’ve worked so hard on this program for such a long a time at this point that’s it’s just so good to finally see it go out in the world, and people are enjoying it, and getting great results from it, and just loving the process of going through it with us. That to me is just so exciting.

Laura: Yeah and it’s really great to have all the feedback because as much as we can prepare for as many different questions and concerns that everyone can have, ultimately everyone’s got a very unique circumstance when it comes to adrenal fatigue.

If one of our customers with the beta program says something like, well this is what I think caused my adrenal fatigue, or this is what I’m really struggling with and I’m wondering if you talk about that in the program. If we haven’t talked about it for whatever reason if it’s really specific, or it’s just something that we didn’t even think to mention, we’re able to add it and cover that topic. Then that way not only for that specific person, but anyone else is going through what that person is going through will actually benefit.

Kelsey: Right.

Laura: We have a lot of knowledge and we have the ability to provide the information, but sometimes it’s like you don’t know what other people are actually…

Kelsey: We need to be prompted to ask.

Laura: Yeah because you don’t always know what people need and sometimes it’s easy to assume that people know certain things that they don’t know, or maybe assume that they don’t know what they do know and then we talk about it too much. It’s like we just want to get the public feedback from it because that just makes the program way more effective for more people.

It’s really fun, and Kelsey and I have done some of this stuff with Chris Kresser’s program, so it’s really fun to be able to do this for ourselves and actually have complete control over what’s going on, which is exciting and horrifying at the same time.

Kelsey: Exactly.

Laura: Alright. Well let’s get into our topic today. Like I said, what we’re going to talk about today is all the different underlying causes of adrenal fatigue which again, this is not going to be a comprehensive, all inclusive list of every possible thing that could cause adrenal fatigue.

Kelsey: That would take far too long.

Laura: That would be a book, so maybe one day. But we’re hoping to cast a pretty wide net and capture a lot of the different potential underlying causes. One thing to remember about adrenal fatigue is that it’s really unlikely that there’s just one thing that causing your adrenal fatigue. Usually it’s a combination of a couple different things that just kind of buildup on each other and eventually become too much for your body to handle.

You may be doing one of these things that we talk about and you’re actually doing okay, you don’t have adrenal fatigue. Maybe that’s because you are taking care of all of the other problems that could potentially impact your risk. Then on the flip side, maybe you’re only doing a little bit of each one, but if you do all of them a little bit, then the overall cumulative effect could be that your body just can’t handle all the stress and it becomes an adrenal fatigue issue. Just something to keep in mind when we go through the causes because again it’s usually a combination of different factors that add up to the problem in the end.

Kelsey: Exactly.

Laura: Alright. First what we are going to talk about is diet. We did kind of cover this a little bit last time, but we’re just going to do a little overview since diet is a pretty common reason that people would develop adrenal fatigue.

What we talked about last time mostly had to do with I guess you would either call it under-nourishment or malnourishment. Under-nourishment, we’re mostly talking about inadequate calories or macronutrients. Then malnourishment is usually referring to inadequate micronutrients.  You’re either under eating, or you’re eating enough but not getting the nutrients that you need. Anyway you look at it, you’re not getting the kind of nutrition that you need to support your adrenal health.

Kelsey: Right. We’ll kind of separate it into these different categories as we go through this. Do we want to talk about inadequate calories first?

Laura: Yeah. I think that’s kind of one of those really easy to happen issues especially in the Paleo community. We did talk about this last time where whether you’re doing just a plain Paleo diet, or if it’s you’re specifically trying to eliminate a certain macronutrient, or if you’re specifically doing a certain form of Paleo for your health condition, so maybe you’re doing an autoimmune type Paleo diet, so maybe you’re doing a low FODMAPs or an SCD type Paleo diet. Any time you cut out a lot of different types of food from your diet, you’re at risk for under eating.

I’m not saying that eliminating grains or any of those foods is going to cause malnutrition. I know that’s a big argument that a lot of conventional RDs will make is that if you don’t eat grains, you’re missing out on all these nutrients. No, that’s not true.

Kelsey: Right.

Laura: But, there is some level of truth to it where if you suddenly cut out a huge part of what you’re normally eating, if you used to eat a lot of grains, if you used to eat a lot dairy, and then suddenly you just remove those from your diet and you don’t replace them with something else that can kind of equivalate their nutritional quality, then that can actually cause you to intake too little calories and be under eating, especially if you’re exercising a lot which makes it even easier to under eat. Once in a while that’s okay and that’s why a lot of people lose a lot of weight when they go on Paleo at first.

Kelsey: Right.

Laura: They have gone from maybe 2500 calories to 3000 in a day and maybe they drop to like 1800 or something. They’re not hungry because they’re eating lots of fat and maybe there’s a lot of adrenaline involved, so that can suppress your appetite for sure. But eventually that will catch up to them and that I think is one of the bigger contributors to adrenal fatigue that we see mostly in the Paleo community I’d say.

Kelsey: Yeah.

Laura: But really anyone who’s trying to address a health concern with a restrictive diet.

Kelsey: Right. This is just so common. I’ve seen it so much. I’m sure you have too, Laura. I actually just had someone today who when she plugged in everything she was eating into a calorie calculator for a few days, she realized that she was only eating like 1200 or 1300 calories a day. I think it’s just really easy not to notice that for a very long time.

Laura: Mm hmm.

Kelsey: It’s worth it if you haven’t already, or you haven’t in a while, just kind of track your calories for a few days. It’s not something we want you to do forever, it’s just to kind of see where you’re at right now with your calorie intake and make any changes based on that to get the appropriate amount of calories for your own body and activity levels.

Laura: Yeah, and that’s something there’s a fine line between being a calorie counter and just having an awareness of what you’re eating. Because again, it may be that you’re just not noticing how little you’re eating. Say you’re intermittent fasting, which some people they do fine on, but then if you’re skipping breakfast, you have to eat the amount of calories you would have eaten at breakfast during the rest of the day.

Kelsey: Right.

Laura: A lot of people don’t compensate there. They’ll just skip breakfast and then eat their normal meals for the other meals. That is again under eating and then that can lead adrenal issues, HPA axis dysregulation when you’re under eating chronically.

That’s one of the reasons we don’t recommend intermittent fasting for people with adrenal fatigue just because it can be really hard to get enough food in if you’re eating in like an 8 hour window. But a lot of my clients that do intermittent fasting don’t even realize that they have to increase their calories during the eating window itself.

Kelsey: Right. Exactly. And not having enough calories, that’s just a huge stressor for the body. It causes low blood sugar and when our blood sugar gets low…and we talked about this, I think we talked about this a little bit in our last podcast…but when blood sugar gets too low, the body has to get more glucose from somewhere. And a lot of times if we’re not eating enough carbs, we don’t have glycogen stored up, all that sort of stuff, it has to create it from something else. Having to create glucose, that is a stressor for the body too.

First when blood sugar dips too low, that automatically sends a signal to the body, like hey, there’s something going on, this is not good. Because actually too low blood sugar can actually kill you. It’s understandable that the body would treat that as a serious threat. You have to be aware of that and know that the body is reacting as if this is, not quite the same degree, but as if this is a life threatening thing. That is of course a stressor for the body to deal with.

Laura: Yeah, and then as far as how the body deals with it, it’s going to be breaking down the fat tissue and the muscle tissue to supply the substrates that it needs for gluconeogenesis. Since cortisol is basically the main hormone that guides that process, it leads to a higher production of cortisol. That can be a problem especially if somebody’s in a later stage of adrenal fatigue because they won’t be able to produce the cortisol they need and then they’re having hypoglycemia issues regularly which can cause a lot of discomfort and a lot of the symptoms that people experience.

We did talk about this last time and I don’t want to over-hash the issue because it’s like we have probably 30 other things to cover in this podcast. But we just have to really kind of hammer that issue home because it always surprises me when my patients are eating the amount they’re eating and think they’re eating enough. And it happens so often that there has got to be some level of disconnect. I don’t know why so many people doing Paleo don’t realize how much they’re under eating. It’s really common with women especially, and the ones that are trying to lose weight, it’s even more common. They’re combining Paleo with like a calorie restricted diet because somebody told them that was the best way to lose the 10 pounds of menopause weight that they put on or something like that.

Kelsey: Right.

Laura: I could go on forever, I get so mad at this stuff.

Kelsey: I know. We’ll maybe have to leave it there. But people, really, you need to eat enough calories. Especially if you’re dealing with any kind of fatigue issues, it’s just so important. Laura and I talk about it all of the time because we just think more people need to know that and kind of check in with themselves to see where their calorie intake is right now and make the changes to get enough for themselves.

Laura: Yeah. Then just beyond calories, we also talked a little bit about macronutrients in our last talk. Even though inadequate fat is definitely a potential contributor to adrenal fatigue, I think what we see more often is the low carb being the contributor.

Kelsey: Mm hmm.

Laura: Again, that’s usually because people are having drops in blood sugar that the body has to accommodate for. If you’re not eating carbs, basically your body has to create carbs. Some people are better at that than others. I don’t know the necessarily biochemical mechanism behind that. But based on my experience, my theory is that there’s differences in people’s…I guess it would be enzymes that do the different either fat metabolism or carb metabolism because people always talk about, oh you just have to become fat adapted.

I honestly, 100% believe that there are people that will never become fat adapted based on lifestyle, based on past medical history, based on the stress that their mother was under when they were being developed in the womb or whatever. I mean there’s so many factors that can affect somebody’s ability to metabolize nutrients that, again, this is again kind of a little bit of a sore spot for me because I have so many clients that are suffering because of it. But the idea of becoming fat adapted is not going to work for everybody.

Kelsey: Right, yeah. I’m totally with you there. I think we’ll probably start to see, I mean depending on how popular the low carb thing becomes, but hopefully we’ll start to see more research about that. But I think actually you just reminded me of something that Chris Masterjohn was talking about I think at the Ancestral Health Symposium like a few years ago. He was talking about how amylase production gets up regulated in some cultures where that we just think of as more…like they do well with carbohydrates. I think there is something to that biochemically. Just so people know, amylase is what breaks down carbohydrates, we have it in our saliva and in our gut too that breaks down carbohydrate as we’re digesting it. I think that there’s a theory there, Laura. I agree.

Laura: Yeah, I guess we’ll have to go get a PHD and study it or something so we can have the information because it drives me crazy.

Kelsey: I know.

Laura: Then of course we were talking about malnourishment. Again, malnourishment is usually more related to micronutrient consumption. Kelsey, do you want to tell our listeners a little bit about a couple of the nutrients that might be a problem.

Kelsey: Yeah. First of all, every time we get stressed and our HPA axis is activated, we actually lose vitamin C and magnesium. Because first of all, vitamin C, we have a really high concentration of that in the adrenal glands themselves. Every time that we get stressed, it just releases that into the body and gets used up.

And magnesium is kind of the same sort of idea. I don’t think it’s stored in the adrenals, but I’ll have to double check on that. But the stores get depleted. And they’ve actually shown that magnesium deficiency leads to HPA axis dysregulation and causes anxiety. It’s pretty interesting stuff. You wouldn’t necessarily think that not having magnesium would have such a distinct effect on the HPA axis, but it truly does.

Laura: Mm hmm.

Kelsey: Then of course, HPA axis dysregulation itself causes anxiety symptoms and that’s exactly what they showed in this study. I think it was on rats, but it wouldn’t surprise me if that was the same case for humans. Unfortunately we just kind of have to go with a lot of rat studies here because we don’t really want to induce magnesium deficiency in humans. It wouldn’t be very nice.

Laura: Yeah, except for the sad part is I’m sure the majority of Americans are already in that state.

Kelsey: Probably true.

Laura: It’s like not necessarily not that far off from what people are already doing. Vitamin C and magnesium are kind of the easy ones because the adrenal glands respond so much to them. But then there’s also lots of other nutrients that will affect just general ability to produce energy. The enzymes that your body uses to turn the food you eat into the actual physical energy that you create, like the ATP which is the form of energy, that requires adequate amounts of certain B vitamins.

Also detoxification processes that the adrenals can get overworked if you have too many toxins, those detox pathways are supported by micronutrients. So things like sulfur, and zinc, and vitamin C is another one that helps that, and vitamin E, and any of those ones that support detoxification, which I’ll talk about in a few minutes.

But just to remind people that nutrient deficiencies can go beyond affecting the adrenal glands, it can affect any organ, and if any organ is under strain for whatever reason, that can potentially affect your HPA axis.

Kelsey: Right, because you have to think about it like this, anytime anywhere in your body something is stressed out, the body responds with the HPA axis activating. As long as there’s something going on that shouldn’t be in the body or external factors that are either causing mental, emotional stress, any kind of that, all of those things affect the HPA axis pretty equally. It just causes it to activate.

Laura: Right. Okay, well let’s keep going with the diet because I just realized we’re already 20 minutes in and we have so many things to cover.

Kelsey: We should probably split this into two maybe.

Laura: We’ll see how much we get through because we don’t want to bore you guys. Hopefully you’re not bored, but there’s a lot of information. Another thing that could be an issue with especially people that aren’t doing Paleo, but even in Paleo diets, its possible people could be having food sensitivities.

Kelsey: Mm hmm.

Laura: If you have a food sensitivity that you’re constantly eating the food that you’re sensitive to, gluten’s a big example there, but that could be anything, that could be dairy. I’m trying to think of some really common ones. A lot of gluten free grains, I have clients that are having reactions to. Even something like eggs, which eggs are usually a very healthy food, but if you’re sensitive to them, then those cuold be causing the chronic inflammation and immune activity that comes from long standing food sensitivities.

Kelsey: Mm hmm.

Laura: A lot of our beta participants were saying part of what they believe contributed to their development of adrenal fatigue was years of un-diagnosed either maybe gluten sensitivity, or celiac disease, or some kind of food sensitivity that they didn’t realize that they had. And once they actually figured it out and removed it, they felt better. But they had already done so much inflammatory damage to their body that the adrenals had to kind of bear the brunt of that. Getting any sort of food sensitivities figured out and getting those foods out of your diet can be helpful.

Once caveat is that actually adrenal fatigue can cause food sensitivities. So if you develop adrenal fatigue, you may find yourself becoming more sensitive to certain foods that you weren’t sensitive to before.

Kelsey: Right.

Laura: That’s going to actually be the case with a lot of the stuff we talk about today.

Kelsey: Right.

Laura: It’s one of those things that’s a vicious cycle.

Kelsey: It’s a two way street.

Laura: Yeah. It’s like these are things that can cause adrenal fatigue, but then if you develop adrenal fatigue, they can also become symptoms.

Kelsey: Right.

Laura: Super clear, right?

Kelsey: Yeah and I’ll say here too, any food sensitivities that you have and you’re still eating those foods, that first of all leaves you open to any sort of gut issues. We’ll jump into gut issues a little bit later too. But that leaves you more open to developing things like SIBO, dysbiosis, or getting some kind of pathogen just because the tissues there are inflamed, they’re irritated, and that just kind of leaves us open to infection.

But also like Laura was saying, when your adrenals are already in the tank, often your levels of secretory IgA are low too. That’s part of your immune system that helps to fight, it’s a marker basically that shows if you’re able to fight things off. It would be high if you’re actively fighting some kind of infection and your body has the wherewithal to actually put up a fight. But often what you’ll see with people with adrenal fatigue is that they’re levels of that are low. That can either mean that the body just can’t put up a fight at all if there is something. Usually to me, I take it as meaning a combination the adrenals are low and probably you have some kind of infection that your body has just been trying so hard to fight off for a really long time and it’s kind of given up.

That’s the same idea, this two way street and vicious cycle sort of thing where it’s just they kind of go together and you have to deal with both at the same time or deal with both eventually otherwise you’re never going to fully heal from both of them.

Laura: Yeah. It’s really hard to figure out. It’s like a very chicken and the egg situation.

Kelsey: Right.

Laura: It’s like did the food sensitivities develop because you have adrenal fatigue? Or did you have them for a long time and now they’re the ones that’s causing the adrenal fatigue?

Kelsey: I think it can happen both ways.

Laura: Yeah, definitely.

Kelsey: I don’t think there isn’t necessarily an answer. It’s just different people develop one side of things first, and it just leads to the other, and then it becomes this viscous cycle.

Laura: Right, right. Another viscous cycle diet that we were talking about a minute ago was the blood sugar control issue. Again, it could be that if you’re having lots of spikes and dips in your blood sugar, that causes your adrenal glands to have to respond to keep your blood sugar balanced. The more that happens, the more effort your adrenals have to put forth.

A lot of times when people have hypoglycemic symptoms, which that’s partially due to the amount of adrenaline and cortisol that the adrenals pump out when your blood sugar drops too low. That’s things like your heart is racing, you’re sweating, maybe you have some body temperature dysregulation. When somebody gets those symptoms, they usually go straight for something like sugar, or caffeine, or something to help deal with those symptoms. Then they’ll feel better for a short period of time, but then they’ll actually get that dip again and then they’ll feel much worse.

That blood sugar roller coaster is a huge issue for adrenal health. Again, that may be from the blood sugar itself being all over the place, or it could be that your adrenal glands can no longer function appropriately and then that’s when your blood sugar starts to get messed up.

Kelsey: Right.

Laura: If you’re finding yourself craving sugar or craving caffeine, or needing caffeine to get through the day more than you used to, it could be because you’re getting adrenal issues. Or if you’re just that kind of person that’s been doing the high sugar, high caffeine intake your whole life just because you like the taste, or going to a Starbucks and getting your grande frappuccino in the morning is just your habit and now you’re starting to experience issues from it, it could have been that that habit that you have is actually what caused the adrenal issues.

Kelsey: Exactly.

Laura: Then there’s always that compounding factor where the more stress you get and the more blood sugar dysregulation you get from the stress, the more caffeine and sugar you’ll consume. Again, another viscous cycle.

Kelsey: Right. Kind of these comfort things that we use when we’re stressed out to either get through it, or make ourselves feel better. There’s lots of different of reasons. But for whatever reason it is, we tend to gravitate toward those kind of things when we’re stressed out.

Laura: Yeah, and it’s crazy because I have one client in particular that I’m thinking of that he said that he was very sensitive to caffeine and we’ve increased his carb intake significantly. He was eating like less than 100 grams of carbs per day and now he’s eating between 150 and 200 grams per day. Now he can tolerate caffeine a lot better.

Kelsey: Wow, that’s interesting.

Laura: Yeah, it’s really interesting to see all the different ways that these dietary factors than interplay.

Kelsey: Right.

Laura: If you’re doing everything right with blood sugar control in the way you’re eating, then maybe caffeine won’t bother you. Something like bulletproof coffee is a good example of a terrible idea of something for somebody with adrenal fatigue because you’re not eating any glucose in the morning, you’re having that caffeine intake so you’re already stimulating the cortisol because caffeine increases your cortisol and adrenaline secretion, and then you have the combination of that with no sugar intake. So then your blood sugar will drop, and then raises your cortisol and adrenaline, and then maybe you start getting hypoglycemic symptoms, and then you want to eat something with sugar in it, but then you don’t because you’re not eating sugar. It’s kind of all over the place.

Kelsey: Right.

Laura: I think there’s lots of people that do fine with that kind of thing. Obviously the bulletproof coffee thing is quite popular, but for somebody with adrenal issues I kind of use that as the example as the absolute worst choice you could make is intermittent bulletproof fasting or whatever you want to call it.

Kelsey: Yeah, I agree there.

Laura: Another thing I could write a whole article on or something.

Kelsey: Exactly.

Laura: But I will shut my mouth about it because again, it’s not everybody, but I’ve seen a lot of people with issues with it.

Kelsey: Maybe we should move on to lifestyle habits that are some causes. I’m going to let you start talking about exercise because I know this is something that you’re interested. I’ll let you take charge of this one here.

Laura: Exercise is one of those crazy things that a lot people can do just fine with certain levels of exercise. Obviously people who are elite athletes do a ton of exercise and they’re not necessarily developing adrenal fatigue. But the thing that people need to remember, again like I mentioned before, training by itself is rarely the primary cause of adrenal fatigue. It may be that it’s kind the biggest factor in somebody’s adrenal fatigue. But if somebody is doing everything right as far as their training schedule, their recovery, their nutrition, their stress management, then they can usually tolerate some pretty high levels of training.

Kelsey: Right.

Laura: Usually it’s the total amount of stress on the athlete that’s exceeding their ability to cope with the stress. Maybe it’s like a recreational athlete that is doing marathon training but also has a 60 hour a week job that is causing them a lot of stress. Maybe they’re not sleeping well, maybe they’re eating low carb, any of those issues that could increase stress can make somebody more prone to over training issues.

Kelsey: We’ve talked about…I think maybe it might have been last time where if you’re train like an athlete, you have to live like an athlete too.

Laura: Right.

Kelsey: They don’t have these kind of other big stressors that are affecting their lives when they’re training that hard. You have to remember that for yourself too. Don’t be training for a marathon when you’re under a ton of work stress, maybe you have some financial issues. All of these things add to your overall burden of stress and that’s what causes the over training.

Laura: Yeah, and then the interesting thing is that both aerobic and anaerobic exercises can be a problem. I think a lot of times when people think of over training, they imagine some kind of marathon runner or something that’s doing a ton of running, and oh obviously they’re going to get adrenal fatigue because they’re in this catabolic type of training. But there’s actually a lot of evidence that even short duration explosive activity like weight training, and sprinting, and certain types of sports that are more explosive like that, if done inappropriately, if done in excess as far as time or multiple days per week and combined with extra stress, it could be just as problematic as someone who’s running 50 miles a week or something crazy.

Kelsey: Mm hmm.

Laura: There’s a lot of evidence in a variety of different types of athletes, so they’ve done it in people like wrestlers, soccer players, long distance runners, people who are doing high level cycling competitions and that kind of thing, even in people who are doing just basic strength training and that of stuff, they have shown that there’s a bunch of different cortisol issues that can come up.

Usually what happens is that there’s high cortisol that happens after exercise, which happens to everybody. That’s not unusual and that’s completely normal for someone to have high cortisol after they workout. But the problem is that it becomes chronically high if they’re exercising too much, if they’re not doing the appropriate behaviors after their exercise, so resting, recovering, eating, having a good post workout meal which will reduce your cortisol levels.

Having that chronically high cortisol from the poor training techniques, that is kind of the first thing that happens. They have that chronically high level, it’s high all time, it’s high at baseline, even it’s high before they start exercising. And then over a period of time, their cortisol drops. Again, this is kind of that same pattern we see in people going from stage one adrenal fatigue into stage three where they go from high cortisol to low cortisol. Some people believe that this a defense mechanism and that’s because the body will become very fatigued more easily when somebody’s cortisol drops low.

Kelsey: Makes total sense, right?

Laura: Then normally that would be a signal that the body to stop exercising and rest.

Kelsey: Right.

Laura: But unfortunately a lot of people ignore this signal. Maybe they have a goal that they want to reach that they think training harder is going to get them to a goal faster. Maybe they are experiencing peer pressure if they’re doing some kind of group activity or team activity where other people are pushing themselves harder. Then sometimes it’s poor coaching. If you’re in a sport and your coach is not paying attention to your fatigue symptoms, pushing you harder than you should, if you’re going to a CrossFit gym and you’re trying to take it easy one day and your coach is giving you a hard time and saying, oh I know you can do more than that.

Kelsey: Right.

Laura: They’re not trying to be malicious or anything, but they’re just trying to motivate you, but they’re overriding your body’s signals. Kind of that constantly ignoring your body’s fatigue and pushing yourself past the point of fatigue is perfect recipe for developing adrenal fatigue.

Kelsey: Right, and I think you bring up an interesting point about overriding these signals. I think that is actually a huge part of adrenal fatigue just in the sense of all the causes. We get stressed out at work, but we feel like there’s nothing we can do about it, we just have to push through it. We exercise too much and our body is telling us we need to slow down, but we just push through it because of all these factors you just mentioned. We’re trying this new diet that’s low carb, it makes us eat too low calories, we feel hungry, but we’re like oh this must be normal, everybody else is doing it, just got to push through it.

I think that’s so common for all of these causes. The take away there is to just really start to try to listen to those signals that your body is giving you because they mean a lot, obviously. They’re trying to tell you that you’re pushing too hard and that your HPA axis and your adrenals just can’t quite keep up with that.

Laura: Right. I think we see a lot of these images where it’s like oh you should leave nothing but blood, puke, and sweat, and tears on the floor when you leave the workout.

Kelsey: Right.

Laura: It’s like, are you serious? If you’re puking during exercise, that is not okay.

Kelsey: Right, not normal.

Laura: You’re clearly doing something wrong. It’s like people just get this feeling like pushing themselves beyond the point of exhaustion is some kind of badge of honor. And honestly, it’s just not good for long term health, it’s not good for long term fitness, you’re going to lose strength. There’s so many things that can happen with over training syndrome. And this isn’t even something that like, oh it’s not a real thing. No, it’s definitely a real thing and it’s studied in the literature to be real.

Overtraining can cause chronic neurotransmitter imbalances, so that can affect your energy and your mood, it can disrupt your sleep, it can cause brain fog.  Over training causes increased levels of inflammation. That suppresses the immune system, it causes muscle breakdown so you lose strength. It can also cause you to hold on to fat more, so you might gain fat when you’re doing all this workout to lose fat. It’s totally counterproductive.

There’s just a lot of different symptoms that over training causes and basically it’s going to give you the exact opposite results of what you’re aiming for with this high level of activity. Not only are you harming your health in the long run, but you’re completely missing the point of exercise.

Kelsey: Exactly.

Laura: It’s just all around bad. Like I said before, the best way to deal with this first of all is to make sure your training program is not completely ridiculous. So making sure there’s rest days in there, making sure that you’re balancing long cardio with shorter cardio or weight training. Or if you’re doing heavy weights a couple days of week, that you’re also doing some walking and maybe some yoga, or mobility work, that kind of stuff so that it’s not five days a week of like a Fran workout where you’re throwing barbells around and ending up on the floor in a sweat pile every day.

Kelsey: Right, and thinking about what your life looks like around that.

Laura: Right.

Kelsey: If you have low stress periods of your life where work is fine, it’s not a buy time at work, that would be a great time if you want to do something a little bit intense to try that. Whereas if you have busy season at work and it’s really stressful, or you have some life stress that’s going at the same time, maybe tone it down a notch for just a little bit until things get a little bit easier and less stressful. You have to really fit your workout plan to what your life looks like in general I would say.

Laura: Yeah and certainly pay attention to things like your sleep. If you’re waking up at 5 am to work out and you’re going to bed at midnight, if you don’t have an option of going to bed earlier, maybe you need to start skipping some of those 5 am workouts to make sure you get the 8 hours of sleep that you need.

Kelsey: Mm hmm.

Laura: Prioritizing the things that help with the recovery, like we talked about with nutrition, this is where making sure you’re getting enough nutrients and calories is really important because if you’re working out a lot, you’re going to have higher levels of nutrient needs. Say you’re going for a 10 mile run or something, you’re going to end up burning 1000 calories or something crazy like that. You need to replace those calories, otherwise you’re basically doing the same thing as someone who is under eating even if you feel like you’re eating enough.

Then there’s lots of adaptogenic supplements that can help, but supplements are never a sliver bullet for this stuff. Even if helps you with a little bit of that fatigue or something, like say you’re training and you’re just a little tired, or maybe you’re just not getting the amount of sleep you’re supposed to get, you just need a little bit of an edge, then sometimes adaptogens can be helpful. But it shouldn’t be like I’m doing CrossFit five days a week and I’m feeling like crap, let me take some rhodiola and I’ll be fine.

Kelsey: Right, it’s not a magic bullet.

Laura: Right, it’s a tool to help, but it shouldn’t be the only thing in your arsenal. Honestly at the end of the day, if you are developing adrenal fatigue and you’re training really hard, you may actually need to quit exercise all together for a period of time in order to heal. We like to try to nip things in the bud and not make somebody have to go to zero days of exercise per week to get better. But I’m not above telling a client to take a break from exercise if I think it’s necessary.

Kelsey: Yeah. If they’re in stage three adrenal fatigue and they feel like they can barely get out of bed, but they’re trying to push themselves through a workout, that just truly isn’t worth it most of the time. They’re just not going to feel better unless they give their body a full chance to rest and recover.

Laura: Yeah. I had a client that I’m pretty sure developed adrenal fatigue from a combination of over training and a low carb diet. I think he had a medical condition that made him more prone to it. I’m trying to remember what it was. It’s when your bilirubin is too high, Gilbert’s Syndrome.

Kelsey: Yeah.

Laura: I think what was happening with him was he was getting too much muscle breakdown, and when you’re breaking down muscle, you do get some level of higher level of those things like bilirubin and…I’m trying to remeber, what’s rhabdomyolysis an excess of? Do you remember? I think it’s red blood cells breaking down or something?

Kelsey: I honestly don’t remember to be honest.

Laura: Okay, we don’t see a lot of rhabdo in our clients.

Kelsey: Yeah, not very common.

Laura: I think he was getting excessive build up because he had Gilbert’s Syndrome and then that was a kind of a toxic stress to his body and he eventually developed, I think he got into stage three adrenal fatigue. When we were working together, he would once a week maybe go try to do something like rock climbing and he would wake up the next day and feel like he had gotten hit by a truck.

Kelsey: Right.

Laura: This was a guy that was two years ago was doing hardcore CrossFit for multiple days a week and then he got to the point where he couldn’t do anything without feeling terrible.

Kelsey: Right.

Laura: He’s feeling a lot better now. As far as I’m aware he’s not back to normal, but I think he knows that normal is going different for him that it was a couple years ago because of what happened. It’s just a really good example.

Kelsey: It can just take a long time too. And you’re right, someone like that they may not ever get back to their old normal, but usually they can feel a lot better, which is good.

Laura: Yeah. It stinks because he was my age, so he was like 27 or 28 and he couldn’t do anything. He couldn’t go out with his friends, he couldn’t drink alcohol, he couldn’t hardly tolerate half the food he was eating.

I see that and it’s almost like I want to use his experience as example for people because a couple years ago he was feeling great and he was going all the Paleo stuff. For whatever reason, like I said, I think it was the Gilbert’s Syndrome in his case, but whatever reason it became an adrenal fatigue issue. If he had known about it and gotten it under control before it got bad, he might have been able to avoid a lot of issues.

Kelsey: Yeah.

Laura: Like I said, he’s feeling better now and he’s able to exercise some, and he’s not feeling as poorly as he did when we started. But it’s a long recovery process if you kind of work yourself into that level of over training syndrome.

Kelsey: Absolutely.

Laura: Anyway, let’s talk about just severe unmanaged stress in general. Do you want to kind of cover that a little bit?

Kelsey: I would classify it as two separate things, though they can be together as well. A severe or chronic unmanaged stress. If they’re combined, it’s even worse.

Laura: Yeah.

Kelsey: Acute severe stressors would be things like a death in the family, a divorce, just really kind of catastrophic events that we don’t plan for, they’re usually a surprise. Sometimes you see it coming, but it’s usually a very quick thing that happens and it kind of shocks your body. That of course is a huge stressor on the body, absolutely activates the HPA axis.

It’s usually not something that goes away immediately. You don’t get over a divorce in a day. But compared to really chronic unmanaged stress, it is a little bit more acute. It might be contained to a few months, or six months, or a year where you’re like dealing with something that one specific problem that really causing a lot of stress. That can be really, really difficult for the body to deal with.

I would say the severe unmanaged stress, that can absolutely push you into adrenal fatigue or HPA axis dysregulation really easily. It happens a lot. Sometimes there might be some other stressors going on beforehand. So maybe someone has a little bit of a gut issue or they just had normal kind of chronic unmanaged stress. But then they get hit with a severe stressor and they notice like within a month that their energy is tanked, they just have all the symptoms of really bad adrenal fatigue. They tend to go through the whole process of stage one, stage two, stage three really quickly.

Laura: Mm hmm.

Kelsey: Your cortisol would shoot up as soon as that severe stressor happened, and then over time, but of much shorter amount of time than usual, so a month or two, you could easily get all the way to stage three. That’s the severe stress and that I would say is pretty common for people to develop really bad adrenal fatigue with severe stress. Because usually that process of going from high cortisol to low cortisol, you kind of notice the symptoms a little bit earlier because it takes some time. You might notice okay, I’m feeling anxious a lot, maybe I have some anxiety, some depression a little bit as cortisol goes up. And then as cortisol starts to get low, you get the fatigue, but it’s not like debilitating fatigue right away. Hopefully you can kind of nip that in the bud before it turns into stage three adrenal fatigue.

Whereas people goes through this accelerated process of developing really bad adrenal fatigue, it’s usually because of one of these very severe stressors that they deal with in their life. I don’t know if you’ve seen kind of the same thing, Laura. But I’ve definitely seen that to be the case for someone with really bad adrenal fatigue it’s pretty common for them to have one of these severe life stressors.

Laura: Yeah, I’ve seen a lot of people that they had a death in the family life being kind of the trigger for that. Say one of their parents died or just family in general. Also job loss I’ve seen.

Kelsey: Yeah.

Laura: Job loss is one of those interesting things that obviously is not not necessarily devastating as a death, but on the flip side, it can kind of trigger a bunch of other stressors like financial issues, self-esteem issues, just anything that could be related to that job loss.

Kelsey: Exactly.

Laura: Like you said, divorce is another thing. Because not only do you have the stress of the divorce itself, but I’m sure there’s some level of buildup of toxic relationship issues going on that led to the divorce itself.

Kelsey: Right.

Laura: Then if you have children with that person, then there’s going to be a continuation of the toxic relationship.

Kelsey: And there’s usually financial problems that go along with that.

Laura: Yeah.

Kelsey: Yeah, you’re right. Whatever the big stressor is, it often kind of has an effect on a lot of other things too. Especially like you said, we don’t necessarily think of a job loss as being equivalent to a death in the family, but the result of all the other stressors that it activates can kind of equal that.

Kelsey: Yeah, that’s the severe stress side of things. Then there’s also chronic unmanaged stress. That’s the other thing that we’re talking about activated by a lot of the severe stressors. Things like financial issues where like you can being dealing with that for years and years and years. It can just be kind of ingrained in you. It’s the little things like sitting in traffic every day, having a long commute every day, the general work stress that just goes along with everyday life. These are the kind of things that you can think about what we were talking about before of like pushing through them because that’s really the most common thing that people kind of do with these sort of chronic stressors is just accept them as what is normal. They’re usually pretty low grade.

They may not be as severe as some of these other big things that we were talking about before and they may be even really tiny. I like to use example a lot of waking up to an alarm which I think we talked about in the last podcast. It doesn’t seem like something that stresses your body out, but if you’re waking up to this scary noise every morning, that actually does activate the HPA axis because it’s startles you. Anytime you’re scared, you’re activating the HPA axis.

Laura: Right.

Kelsey: Even things that you wouldn’t think of that are stressful, those are the kind of stressors, they’re low grade, they’re happening on a daily basis and a lot of times we are just pushing through them and not really paying attention to them. Those are the things that really overtime, and it’s always in combination with other stressors. Like we said, it could be in combination with a severe acute stressor, it could be in combination with a gut pathogen that came around, or excessive exercise. But all of these stressors in addition to something maybe a little bit kind of pushes you over the edge, that an absolutely lead to HPA axis dysregulation, for sure.

Laura: Yeah, kind of like that whole straw, camel, back analogy.

Kelsey: Yeah.

Laura: It’s like every time your alarm buzzes really loud, an obnoxious way to wake up in the morning, that’s a straw.

Kelsey: Right.

Laura: Maybe those are not the straws that end up breaking the camel’s back, but then your mother dies and then you pile on ten more straws. Then everything adds up to the point where at some point you cross that threshold, and then that’s when all the problems start happening.

Kelsey: Exactly.

Laura: You can’t avoid a lot of these severe stress instances, people are obviously going to die. But circumstances are going change, maybe there will be some financial problems. But again, because of it’s a cumulative effect, everyone that has a death in the family is not going to develop adrenal fatigue.

Kelsey: Right.

Laura: It’s just really a combination of all the different things. That’s why in our program we try to focus on the daily chronic stressors because there is some level of control over that.

Kelsey: Mm hmm.

Laura: Whereas like I said with the big ones, even things like getting a sickness, I’ve had patients that got Epstein Barr virus and then that was kind of triggered things. You can’t avoid all of that stuff and I don’t want people to feel totally freaked out like everything is going to cause adrenal fatigue, but we just want people to focus on the things that they can control because that’ll reduce the risk when the bigger things do happen.

Kelsey: Right, because basically what we’re trying to do with program is to build up your resiliency, build up your HPA axis so that it responds to stress normally and then it knows to shut down the HPA axis and not produce cortisol when there isn’t a stressor around. Because what happens is basically any of these big stressors, they actually kind of prime HPA axis for future activation. Let’s something bad happened when you were younger and that basically tells your HPA axis okay, there’s something really bad that happened, so now I have to be ready for other bad things to happen and I have to be able to turn on immediately and have a really big response next time something happens because it kind of learned from that first experience.

The more we can do to shut down and kind of relax in between big stressors or reduce just the chronic every day stressors that are going on, the more resilient the HPA axis can become and the less primed for action it becomes which is what we want. We want it to be able to only spring into action when it needs to and not just be ready at anything, even just a small little thing that could stress you out should not be treated the same as one of these severe stressors that we just talked about.

Laura: Right. Cool. Well, I just noticed that we are rounding out close to an hour at this point. We got through I’d say half of what we wanted to talk about.

Kelsey: Yeah, I think that was half.

Laura: I think what we’re going to is we’ll do a two part episode for this one. We might either do this in two weeks, or maybe just do it next week just to kind of get through it and make sure you guys get all the information that you need. But either way, we have a bunch of other things that we want to talk about and plenty of things to say about the other, I guess we have probably five or six other topics that could potentially be causing adrenal fatigue.

We don’t want to get you guys into a coma of boredom here, but talking for two hours. What we’ll do is we will hold off on the rest of this information until next time. But if you are interested in learning a little bit more about adrenal fatigue, if we peaked your interest, if you’re starting to feel like you need to start looking into what to do because you’re recognizing yourself in some of these stories we’re telling, then we recommend getting our 28 page e-book on the topic.

Kelsey: For free.

Laura: Yeah, it’s totally free. Isn’t that awesome? I feel like we’re giving away something that should be sold, but it’s for free. All we need you to do is sign up for our adrenal fatigue program email list so that way you get updates about things. We’ll let you know when other podcasts come out, when training videos come out so you can get all the information you need about how to heal from adrenal fatigue. We do give you three easy steps to start implementing in the e-book. We’ll link to that sign up link in the show notes. You can also go to MyPaleoRehab.com and find it there.

But otherwise, we will continue this next time and cover all sorts of other things that could potentially be causing your adrenal fatigue if you have it or if you think you’re at risk for it. Either way, you don’t want to be missing this information because we want to make sure nobody ends up with adrenal fatigue. Or if you have it already, we’re going to help you get out of it.

Kelsey: Yeah. Awesome. I’m looking forward to part two.

Laura: Me too. I feel like we have all this really great information and when we were writing the outline for the podcast, I think both Kelsey and I were looking at it and saying this is turning into a lot more than we thought it was going be.

Kelsey: Exactly.

Laura: Kind of the same way with the e-book. I think we wrote it in a day and were just like, well let’s just give them some information about what they should do, and then it turns into this massive thing.

Kelsey: I know.

Laura: Hopefully it’s not more information than you guys want. But I feel a lot of our patients always like to have more information because it just makes them better informed. So hopefully you guys are enjoying this stuff.

Kelsey: Yeah and we keep it simple too. There’s a lot of information in there, but we hopefully put it in there in a very digestible manner that you can really understand what’s going on and pull out the really important pieces to put into practice right away.

Laura: Right. At the end of the day, the most important thing is what to do. We try to make that really clear, but also know a lot of you because you’re science geeks or you like knowing about why you’re making the changes, then having the information really helps kind of put all the pieces together for you so that way you’re not just like well she’s just telling me to eat carbs, and I thought carbs were going to kill me, and she’s not explaining this. We want to make sure you guys are on board with the recommendations.

Kelsey: Yes. We like to explain why you should do something because you’re more likely to do it if you understand why.

Laura: Right. Also, who wants to just follow like a little lemming? I was going to say a lemur, but a lemming.

Kelsey: A lemming, yeah.

Laura: We don’t want any lemmings, we want you all to have informed decision making and part of that is getting educated. We think this e-book will help.

Kelsey: Yeah.

Laura: Anyway, thanks for joining us for the 20th episode. I can’t believe it’s been 20 episodes already.

Kelsey: Amazing.

Laura: Next time it’s going to be like 200 and we’ll be like, where did the time go?  But just remember either it’s going to be either in a week or two weeks, I don’t want to tease people and say a week, but I almost feel like knowing Kelsey and I, we just want to get this stuff out there.

Kelsey: Right.

Laura: But we do our best to get this next episode for you as quickly as possible so that we can finish the story. But hope you enjoyed our episode today and we will look forward to seeing you around next time.

Kelsey: Alright. You take care, Laura.

Laura: You too, Kelsey.


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I'm a women's health expert and a registered dietitian (RD) with a passion for helping goal-oriented people fuel their purpose.

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