The adrenal glands are two small triangular organs that hover over the kidneys. They regulate hormones, adrenaline, and most important, the body’s immune and stress responses.1Long K, Azizan E. The adrenal gland and primary aldosteronism: anatomy, steroidogenesis, regulation, and genetic insights. Front Endocrinol. (Lausanne). 2026 Jan 12;16:1736534. https://doi.org/10.3389/fendo.2025.1736534 The adrenals are also part of the hypothalamic–pituitary–adrenal (HPA) axis, which connects the central nervous system to the endocrine system and influences nearly all physiological processes.
Adrenal glands play an integral role in a person’s ability to maintain homeostasis. Keeping internal networks running smoothly, regardless of outside factors, is vital for ongoing good health.1Long K, Azizan E. The adrenal gland and primary aldosteronism: anatomy, steroidogenesis, regulation, and genetic insights. Front Endocrinol. (Lausanne). 2026 Jan 12;16:1736534. https://doi.org/10.3389/fendo.2025.1736534
Adrenal fatigue can affect blood pressure, weight, mood, libido, and reproduction, and it may cause symptoms like abdominal pain, brain fog, exhaustion, and overall weakness.2Huecker MR, Bhutta BS, Dominique E. Adrenal insufficiency. StatPearls. 2023;Aug 17. https://www.ncbi.nlm.nih.gov/books/NBK441832/?report=reader#_NBK441832_pubdet_2
The HPA axis regulates our stress response
As one of the most crucial neuroendocrine systems, the HPA axis controls our primary stress response. External stressors are constant, and the HPA axis reacts through a complex communication system that controls metabolism, immune defenses, nervous system function, and hormone production.3Sheng JA, Bales NJ, Myers SA, et al. The hypothalamic-pituitary-adrenal axis: development, programming actions of hormones, and maternal-fetal interactions. Front Behav Neurosci. 2021 Jan 13;14:601939. https://doi.org/10.3389/fnbeh.2020.601939
Anything from physical injury or infection to pressure at work or home can trigger a cascade of stress hormones. Even environmental changes (pollution, chemical exposure) are capable of brewing a stress storm.
The hypothalamic and pituitary glands signal the adrenals to release cortisol, a powerful hormone that increases blood sugar, elevating focus, heart function, and immune response.4Kaur J, Gandhi J, Sharma S. Physiology, cortisol. StatPearls. 2025;Dec 1. https://www.ncbi.nlm.nih.gov/books/NBK538239/?report=reader#_NBK538239_pubdet_
This short-term stress correction is often referred to as “fight or flight.” It’s an innate survival system that temporarily ramps up performance to protect us from harm. With ongoing chronic stress, however, the body remains on high alert.5Dhabhar FS. The short-term stress response—mother nature’s mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Front Neuroendocrinol. 2019;49:175-192. https://doi.org/10.1016/j.yfrne.2018.03.004
A persistently heightened stress response can wreak havoc on health.6Yiallouris A, Tsioutis C, Agapidaki E, et al. Adrenal aging and its implications on stress responsiveness in humans. Front Endocrinol. (Lausanne). 2019 Feb 7;10:54. https://doi.org/10.3389/fendo.2019.00054 The adrenal glands become “tired” and no longer function properly, resulting in adrenal fatigue.
Treating Adrenal Fatigue
Treatment may include lifestyle changes, particularly stress management and improved sleep quality, or a hormone supplement (like dehydroepiandrosterone). Steroid medications are typically reserved for adrenal insufficiency, a more serious, often lifelong condition.2Huecker MR, Bhutta BS, Dominique E. Adrenal insufficiency. StatPearls. 2023;Aug 17. https://www.ncbi.nlm.nih.gov/books/NBK441832/?report=reader#_NBK441832_pubdet_2
Adrenal fatigue can be difficult to treat, says Kasey Holland Hamski, ND. “If someone is dealing with unresolved infections, mold exposure, long-term inflammation, trauma, poor sleep, or nutrient deficiencies, the body remains in a stress state, even when the adrenals are being supported. Conventional medicine tends to focus on more severe, end-stage adrenal function, like Addison’s disease. Naturopathic medicine pays close attention to early and functional hormonal changes and patterns where cortisol output, rhythm, and stress resilience are impaired, even if labs appear normal.”
Four-Part Approach to Restoring Adrenal Health
Dr. Holland has a four-pronged, personalized treatment plan for addressing adrenal fatigue:
- First is equilibrium. “If stabilization issues are not addressed,” she notes, “nothing else sticks.” This means regulating the nervous system and balancing blood sugar while focusing on sleep quality and circadian rhythms.
- Identify what’s driving the stress response by looking at chronic infections, gastrointestinal dysfunction, inflammatory triggers, toxin exposure, or unresolved emotional stress.
- Provide dietary and biochemical support with targeted nutrients, botanicals, and adaptogens tailored to the patient’s unique cortisol patterns and history. A nutrient-dense, low-sugar diet rich in anti-inflammatory foods is ideal.
- Teach patients about breathwork, paced activity, trauma-informed care, and redefining productivity goals to help keep their nervous systems in check.
“Healing sometimes requires slowing down,” Dr. Holland says, “but this can be challenging because many people with [adrenal fatigue] are high functioning, driven, and used to pushing through exhaustion. Recovery requires behavioral and nervous system changes, which take time, not just supplements and medications as a quick fix.”
Nutritional Support for Adrenal Exhaustion
Although supplements are not designed as standalone treatments, they can help support adrenal recovery.
Adaptogenic herbs such as ginseng, rhodiola, and ashwagandha promote balance and resilience, especially during stressful times.7Panossian AG, Efferth T, Shikov AN, et al. Evolution of the adaptogenic concept from traditional use to medical systems: pharmacology of stress- and aging-related diseases. Med Res Rev. 2020;41(1):630-703. https://doi.org/10.1002/med.21743 Research suggests ashwagandha considerably decreases cortisol levels in mentally stressed (but healthy) adults.8Toth-Meszaros A, Garmaa G, Hegyi P, et al. The effect of adaptogenic plants on stress: a systematic review and meta-analysis. J Funct Foods. 2023;108. https://www.sciencedirect.com/science/article/pii/S1756464623002955 Adaptogens have been shown to support adrenal function, adrenal hormones, and HPA axis activity.9Liao L, He Y, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018 Nov 16;13:57. https://doi.org/10.1186/s13020-018-0214-9
Amino acids may also positively influence cortisol levels. In one study of people who performed intense workouts, a combination of arginine, valine, and serine suppressed cortisol without affecting other parameters, such as glucose.10Tsuda Y, Murakami R, Yamaguchi M, Seki T. Acute supplementation with an amino acid mixture suppressed the exercise-induced cortisol response in recreationally active health volunteers: a randomized, double-blinded, placebo-controlled crossover study. J Int Soc Sports Nutr. 2020 Jul 23;17(1):39. https://doi.org/10.1186/s12970-020-00369-2 This effect is significant, as exercise, despite its many health benefits, can be a stressor.
Antioxidants work to counteract oxidative stress in the body caused by adrenal fatigue and hormone imbalances. Vitamins C and E, carotenoids, selenium, zinc, polyphenols, and coenzyme Q10 could reduce the risk of tissue damage and other illnesses connected to oxidative stress.11Patani A, Balram D, Yadav V, et al. Harnessing the power of nutritional antioxidants against adrenal hormone imbalance-associated oxidative stress. Front Endocrinol. (Lausanne). 2023 Nov 30;14:1271521. https://doi.org/10.3389/fendo.2023.1271521
Balanced blood sugar is crucial for optimizing adrenal function. Nutrients that help stabilize blood sugar include omega–3 fatty acids, B vitamins, vitamin D, magnesium, chromium, and iron.12Basiri R, Seidu B, Cheskin LJ. Key nutrients for optimal blood glucose control and mental health in individuals with diabetes: a review of the evidence. Nutrients. 2023 Sep 10;15(18):3929. https://doi.org/10.3390/nu15183929
“Adrenal healing isn’t linear, as the body is always trying to adapt with [fluctuating] cortisol and blood sugar patterns,” notes Dr. Holland. “Healing is about recalibrating a complex system and restoring trust between the brain and the body. Lasting adrenal recovery happens when the body learns it’s safe again and able to quickly regulate after a stressful event.”
Footnotes
- 1Long K, Azizan E. The adrenal gland and primary aldosteronism: anatomy, steroidogenesis, regulation, and genetic insights. Front Endocrinol. (Lausanne). 2026 Jan 12;16:1736534. https://doi.org/10.3389/fendo.2025.1736534
- 2Huecker MR, Bhutta BS, Dominique E. Adrenal insufficiency. StatPearls. 2023;Aug 17. https://www.ncbi.nlm.nih.gov/books/NBK441832/?report=reader#_NBK441832_pubdet_2
- 3Sheng JA, Bales NJ, Myers SA, et al. The hypothalamic-pituitary-adrenal axis: development, programming actions of hormones, and maternal-fetal interactions. Front Behav Neurosci. 2021 Jan 13;14:601939. https://doi.org/10.3389/fnbeh.2020.601939
- 4Kaur J, Gandhi J, Sharma S. Physiology, cortisol. StatPearls. 2025;Dec 1. https://www.ncbi.nlm.nih.gov/books/NBK538239/?report=reader#_NBK538239_pubdet_
- 5Dhabhar FS. The short-term stress response—mother nature’s mechanism for enhancing protection and performance under conditions of threat, challenge, and opportunity. Front Neuroendocrinol. 2019;49:175-192. https://doi.org/10.1016/j.yfrne.2018.03.004
- 6Yiallouris A, Tsioutis C, Agapidaki E, et al. Adrenal aging and its implications on stress responsiveness in humans. Front Endocrinol. (Lausanne). 2019 Feb 7;10:54. https://doi.org/10.3389/fendo.2019.00054
- 7Panossian AG, Efferth T, Shikov AN, et al. Evolution of the adaptogenic concept from traditional use to medical systems: pharmacology of stress- and aging-related diseases. Med Res Rev. 2020;41(1):630-703. https://doi.org/10.1002/med.21743
- 8Toth-Meszaros A, Garmaa G, Hegyi P, et al. The effect of adaptogenic plants on stress: a systematic review and meta-analysis. J Funct Foods. 2023;108. https://www.sciencedirect.com/science/article/pii/S1756464623002955
- 9Liao L, He Y, Li L, et al. A preliminary review of studies on adaptogens: comparison of their bioactivity in TCM with that of ginseng-like herbs used worldwide. Chin Med. 2018 Nov 16;13:57. https://doi.org/10.1186/s13020-018-0214-9
- 10Tsuda Y, Murakami R, Yamaguchi M, Seki T. Acute supplementation with an amino acid mixture suppressed the exercise-induced cortisol response in recreationally active health volunteers: a randomized, double-blinded, placebo-controlled crossover study. J Int Soc Sports Nutr. 2020 Jul 23;17(1):39. https://doi.org/10.1186/s12970-020-00369-2
- 11Patani A, Balram D, Yadav V, et al. Harnessing the power of nutritional antioxidants against adrenal hormone imbalance-associated oxidative stress. Front Endocrinol. (Lausanne). 2023 Nov 30;14:1271521. https://doi.org/10.3389/fendo.2023.1271521
- 12Basiri R, Seidu B, Cheskin LJ. Key nutrients for optimal blood glucose control and mental health in individuals with diabetes: a review of the evidence. Nutrients. 2023 Sep 10;15(18):3929. https://doi.org/10.3390/nu15183929
