Feeling frazzled? If you’re constantly tired, cranky, and prone to cravings and temper outbursts, you may have adrenal burnout.

Adrenal burnout, or exhaustion, is rapidly becoming the disease of the 21st century, rivalling other health concerns like heart disease, diabetes and obesity. Despite this, it is not a medically-accepted condition. Integrative physician Dr Jacob Teitelbaum explains, “Many physicians do not recognise any intermediate states between a totally destroyed adrenal gland, which is life-threatening, and a healthy adrenal gland. It is black or white – there is no in between.”

Adrenal burnout is not new: the effects of stress on the body in general and the adrenal glands in particular were first identified by endocrinologist Hans Selye in 1935. He discovered that the adrenals – triangular glands sitting over your kidneys which produce the hormones adrenaline, cortisol, DHEA, aldosterone, oestrogen, and testosterone – drive the body to respond to physical stressors by producing more cortisol, moving it from a state of alarm (the ‘fight or flight’ response) to resistance (getting used to the stressor), and finally to exhaustion. Severe, prolonged stress significantly weakens the body and may even lead to death. While most people are hopefully not so stressed that death is imminent, far too many of us are in this exhaustion phase. “People who are worriers, who have a lot of life problems and stress over them, are more affected by adrenal burnout,” adds Dr Jacob Teitelbaum

The extra cortisol produced by the adrenals under stress elevates blood sugar and blood pressure and dampens the immune response. Adding insult to injury, excess circulating cortisol increases weight gain, especially around the mid-section; it is also a factor in the onset of metabolic syndrome. If the stress is continuous, the adrenals then lose their ability to produce enough cortisol, which may predispose chronic fatigue syndrome, fibromyalgia, depression, and hypothyroidism. And, as people with adrenal exhaustion feel totally worn out and lack enjoyment in life, they may be prescribed antidepressants. Before reaching for that prescription, though, there are several things you can do to boost your adrenal health.

What you can do

Get tested This involves determining cortisol levels, along with serum, saliva and urine tests. Adrenocorticotropic Hormone (ACTH) and glucose tolerance and inflammatory markers (ESR and CRP) can also check cortisol activity, but are not essential to verify adrenal burnout, as symptoms usually indicate adrenal insufficiency. Teitelbaum prefers to base his treatment on symptoms, adding that “most people with hypoglycaemia (low blood sugar) have underactive adrenals.”

Review your diet Avoid caffeine – it whips the adrenals to keep going and will only exhaust them further. Eating smaller, frequent meals will reduce stress-induced sugar cravings. Skip ‘white’ foods – pasta, flour, potatoes – as they create a surge of sugar in the body. Instead, eat wholegrains, regular amounts of protein (including protein powders), and two pieces of fruit daily.

Take out nutritional insurance Vitamin C keeps the adrenals functioning, and when the body is stressed, there is greater potential to lose it via the urine. To restore levels, aim for 2,500mg daily; to maintain optimal adrenal and immune function, take 1,000mg. Vitamin B5 deficiency causes adrenal shrinkage: take 100-150mg daily, although some practitioners suggest more. And if cortisol is low, coenzyme Q10 may be low: take 150-300mg daily.

Try herbal helpers Licorice increases the amount of circulating cortisol, so it is indicated for a state of adrenal exhaustion, rather than during the alarm phase. (Note: Licorice also promotes sodium and fluid retention, which can initiate hypertension. It is not recommended in liver or kidney disease.) Adaptogenic herbs – Korean ginseng, Siberian ginseng, ashwagandha, rhodiola, and rehmannia – are ideal for adrenal exhaustion.

Have a reality check The most important issue is how you respond to stress or the possibility of stress. “All work and no play” can have a more sinister outcome than just being dull. Undertake an honest assessment of your life, and make time for relaxation, sleep, socialising, and exercise.

Are you at risk?

Signs and symptoms of adrenal burnout include:
* Constant exhaustion
* Being irritable when hungry
* Low blood pressure
* Dizziness on standing
* Continual thirst
* Recurrent infections
* Difficulty recovering from illness
* Thinking life is a constant crisis
* Feeling overwhelmed

Kara’s story: “I feel calmer and less likely to crave carbs and stimulants.”
Kara is a 38 year-old mother of three children under seven, who works in her husband’s business. She recently moved to a suburb 45 minutes away from her family and friends. Over the past year, she has become fatigued, apathetic and irritable, describing herself as having “a short fuse” and overreacting to minor events, and worrying constantly about her kids, husband, and finances. She regularly skips meals, surviving on coffee (6-7 cups a day) and potato crisps and chocolate biscuits in the afternoon. Her weight has increased, especially around the middle, and she has had continual sinus infections. During our consultation, she appeared tearful and defeated.

My prescription for Kara included: vitamin C (2.5 grams, twice daily), magnesium citrate (300mg daily), B-complex (1 tablet daily), CoQ10 (150mg daily), and a herbal formula containing licorice, Siberian ginseng, rhodiola and ashwagandha. I suggested she reduce her caffeine intake to two cups daily, and eat smaller, protein-rich meals. We also identified Kara’s interest in scrapbooking and reading; importantly, she agreed that ‘time out’ was essential. After two months, Kara appears brighter and more relaxed. She has joined a book club, walking group, and scrapbooking class, and describes her symptoms as “less intense”.

Nicola Howell is a Melbourne naturopath, herbalist, nutritionist and health writer. Visit her at