Is Adrenal Fatigue Real?

Treatments for Adrenal Fatigue – Adrenal Fatigue – Is it Real? Part 2

In part one if this article on Adrenal Fatigue and Hypothalamic-Pituitary-Adrenal (HPA) Axis Dysregulation we discussed what the adrenals are and how they function, along with what causes the dysfunction in the first place! We also discussed the most common characteristics of this dysfunction, which are listed again below. In part two, we will discuss some of the best evidence-based natural treatments for adrenal fatigue.

What are the Most Characteristic Signs of Adrenal Fatigue or HPA Axis Dysregulation?

Treatments for Adrenal Fatigue

Now that you suspect that you may have an HPA axis issue we can discuss some of the most evidence based treatments for adrenal fatigue. In this case it is important to rule out what is most likely your cause, is it stress, exercise (or lack of exercise), dietary patterns or lifestyle based? This is the case for many and the suggestions below can go a long way to improving how you feel! If there is an underlying infection, or more complex hormonal problem seek out help to get to your best self sooner!

One of the most critical things to consider in the treatment of HPA axis issues is to moderate your activities. If you exercise too much then try decreasing your cardio for a few weeks, if not enough add walking into your routine.

  • Eating well balanced meals (protein, fat and carbohydrates) every 3-4 hours is also a critical component to keeping blood sugar regulated and keeping your adrenal glands calm.

  • Walking. This is my very favourite of all treatments for HPA axis dysregulation! Walking 30 minutes at least 3 times per week, preferably in nature, has been shown to decrease feelings of stress, decrease cortisol and improve mood. Now that is a natural medicine! Walking is also a great way to burn belly fat and get quality time with other stressed friends who are looking for a break as well1,2.
  • Phosphatidylserine is one of my favorite interventions for people who feel wired but still worn out. It has been shown to lower cortisol levels and the HPA axis respond properly to stress. The added bonus with phosphatidylserine is that it is helpful with brain fog and memory issues associated with HPA axis dysregulation3,4,5

  • Glycyrrhiza Glabra is a tasty herb that seems harmless but should be used with caution. Glycyrrhiza can increase circulating cortisol by decreasing its breakdown in the body. As such, if you have high cortisol levels to start with it can make you feel much worse! On the other hand, in someone with low cortisol licorice can be incredibly helpful, increasing energy and contributing to a feeling of refreshed sleep 6,7.

  • Withania somnifera is one of the most versatile adaptogens that works to calm the stress response and anxiety. It can also modulate the immune system and has the potential contribute to insulin sensitivity and thyroid hormone conversion. Sounds too good to be true, right 8,9?

  • Eleutherococcus senticosus is a great herb for burnout and to increase performance in fatigued professionals! After 12 weeks this study showed significant improvement in feeling of burnout10.(Another helpful tip: In another study Eleutherococcus senticosus was able to decrease the symptoms of fatigue, headache, nausea and vomiting with a hangover.

  • Holy basil – (Ocimum Sanctum) as a tea or a tincture can be very calming to the system, decreasing the response to stress and also increasing resilience. A new study on Holy Basil also suggests that it can increase cognition and performance 11,12.

The most important thing to consider when dealing with any type of HPA axis dysregulation is that perception = physiology. When someone cuts in front of us in line, or when your spouse leaves the toilet seat up, again, all of these things can stress our HPA axis and steal our energy! As we work together to learn to breath and move forward, along with adding targeted supplementation, you will rediscover the sense of ease and vitality that you once knew!


  1. Toda M, Den R, Hasegawa-Ohira M, Morimoto K. Effects of woodland walking on salivary stress markers cortisol and chromogranin A. Complement Ther Med. 2013;21(1):29-34. doi:10.1016/j.ctim.2012.11.004.
  2. Miyazaki Y, Ikei H, Song C. Forest medicine research in Japan. Nihon Eiseigaku Zasshi. 2014;69(2):122-135.
  3. Hellhammer J, Hero T, Franz N, Contreras C, Schubert M. Omega-3 fatty acids administered in phosphatidylserine improved certain aspects of high chronic stress in men. Nutr Res. 2012;32(4):241-250. doi:10.1016/j.nutres.2012.03.003.
  4. Hellhammer J, Vogt D, Franz N, Freitas U, Rutenberg D. A soy-based phosphatidylserine/ phosphatidic acid complex (PAS) normalizes the stress reactivity of hypothalamus-pituitary-adrenal-axis in chronically stressed male subjects: a randomized, placebo-controlled study. Lipids Health Dis. 2014;13:121. doi:10.1186/1476-511X-13-121.
  5. Hellhammer J, Fries E, Buss C, et al. Effects of soy lecithin phosphatidic acid and phosphatidylserine complex (PAS) on the endocrine and psychological responses to mental stress. Stress. 2004;7(2):119-126. doi:10.1080/10253890410001728379.
  6. Soma R, Ikeda M, Morise T, Miyamori I, Takeda R. Effect of glycyrrhizin on cortisol metabolism in humans. Endocr Regul. 1994;28(1):31-34.
  7. Kageyama Y, Suzuki H, Saruta T. Glycyrrhizin induces mineralocorticoid activity through alterations in cortisol metabolism in the human kidney. J Endocrinol . 1992;135 (1 ):147-152. doi:10.1677/joe.0.1350147 .
  8. Pratte MA, Nanavati KB, Young V, Morley CP. An alternative treatment for anxiety: a systematic review of human trial results reported for the Ayurvedic herb ashwagandha (Withania somnifera). J Altern Complement Med. 2014;20(12):901-908. doi:10.1089/acm.2014.0177.
  9. Gannon JM, Forrest PE, Roy Chengappa KN. Subtle changes in thyroid indices during a placebo-controlled study of an extract of Withania somnifera in persons with bipolar disorder. J Ayurveda Integr Med. 2014;5(4):241-245. doi:10.4103/0975-9476.146566.
  10. Jacquet A, Grolleau A, Jove J, Lassalle R, Moore N. Burnout: evaluation of the efficacy and tolerability of TARGET 1(R) for professional fatigue syndrome (burnout). J Int Med Res. 2015;43(1):54-66. doi:10.1177/0300060514558324.
  11. Sampath S, Mahapatra SC, Padhi MM, Sharma R, Talwar A. Holy basil (Ocimum sanctum Linn.) leaf extract enhances specific cognitive parameters in healthy adult volunteers: A placebo controlled study. Indian J Physiol Pharmacol. 2015;59(1):69-77.
  12. Bathala LR, Rao CV, Manjunath S, Vinuta S, Vemulapalli R. Efficacy of Ocimum sanctum for relieving stress: a preclinical study. J Contemp Dent Pract. 2012;13(6):782-786.