Quick answer: Your adrenal glands make cortisol, DHEA, aldosterone and adrenaline, the hormones that help you wake up, handle stress and regulate blood pressure. Chronic stress, poor sleep and blood sugar swings can disrupt the daily cortisol rhythm, leading to fatigue, brain fog, belly weight gain and poor recovery. Support focuses on sleep, steady blood sugar, stress practices, and nutrients such as magnesium, B vitamins and vitamin C.
Key takeaways
The adrenal glands make cortisol, DHEA, aldosterone and adrenaline, which shape energy, stress response and blood pressure.
Chronic stress, poor sleep and blood sugar swings can disrupt the daily cortisol rhythm and show up as fatigue and poor recovery.
Sleep, steady blood sugar, stress practices and nutrients like magnesium and B vitamins form the core of adrenal support.
What your adrenal glands make
Cortisol is your main stress and wake-up hormone, and DHEA is a hormone precursor that declines with age and chronic stress. Aldosterone regulates blood pressure and electrolytes, and adrenaline and small amounts of sex hormones handle quick stress responses and hormone balance.
How chronic stress affects the adrenals
Overwork, short sleep, processed food and constant notifications can keep the stress system switched on. Over time, the cortisol rhythm can shift through recognizable patterns: high and wired, then mistimed, then flat and depleted. The adrenal glands are not “burned out”; the brain-adrenal communication (the HPA axis) is dysregulated. Read more in adrenal fatigue vs. adrenal dysfunction.
Nutrients that support the stress response
- Adaptogens: such as ashwagandha, rhodiola and holy basil (see understanding adaptogens)
- B vitamins: especially pantothenic acid (B5) and B6, which the body uses to make stress hormones
- Vitamin C: highly concentrated in the adrenal glands
- Magnesium: used up faster under stress (see who should consider magnesium)
- Phosphatidylserine: studied for blunting cortisol responses to stress
- Licorice root: can prolong cortisol activity but raises blood pressure; use only under supervision. DGL licorice does not have this effect.
Amounts should be individualized.
Lifestyle foundations
Keep a consistent sleep schedule, ideally in bed before 11 pm, and eat protein and healthy fat at regular meals to steady blood sugar. Get morning daylight, choose moderate exercise, since very intense training can add stress when you are depleted, and limit caffeine after noon.
Signs things are improving
Signs that things are improving include waking more refreshed, steadier energy without an afternoon crash, and fewer salt or sugar cravings, along with better mood, libido and exercise recovery.
Stress hormones and healthy aging
Cortisol and DHEA help coordinate communication between the brain, immune system and metabolism. When that signaling stays distorted for years, chronic inflammation rises and the body’s repair processes fall behind. Supporting a healthy stress rhythm is part of aging well. Related: DHEA-S explained.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you feel exhausted, wired but tired, or crash every afternoon, or if stress has changed your sleep, weight or mood. The same is true if you want help choosing adaptogens or nutrients safely, or if you have high blood pressure or take steroids and want to support stress resilience.
See a medical provider promptly for dizziness or fainting, very low blood pressure, salt craving with darkening skin, unexplained weight loss or vomiting. These can be signs of adrenal insufficiency, a medical condition.
What the research shows
Ashwagandha is the most studied herb for the stress response. In a 2019 randomized, double-blind trial by Lopresti and colleagues, 60 stressed but healthy adults took 240 mg of a standardized ashwagandha extract or a placebo once daily for 60 days. Anxiety scores fell more with ashwagandha, and morning cortisol and DHEA-S dropped more than with placebo, with no side effects reported. It was a small, short trial of one branded extract.
Phosphatidylserine has a smaller evidence base. In a 2004 study by Hellhammer and colleagues, 80 adults in four groups of 20 took 400, 600 or 800 mg of a soy phosphatidylserine complex or a placebo daily for 3 weeks before a standard public speaking and math stress test. The 400 mg group had a blunted cortisol and ACTH response and less distress, but the higher doses did not. Results that appear at only one dose need confirmation before firm conclusions.
Running on empty? Let us look at your stress pattern.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Could my energy and stress symptoms reflect a disrupted cortisol rhythm, and how would we check?
Which labs or assessments would help us understand my stress response in my case?
Which daily habits are most likely to make a difference for my stress response for me?
How long would it be reasonable to try these steps for my stress response before we review them together?
Frequently asked questions
What are signs of adrenal dysfunction?
Common patterns include morning exhaustion, afternoon crashes, feeling wired at night, cravings, poor stress tolerance and slow recovery.
Is adrenal fatigue a real diagnosis?
No. The symptoms are real, but they are better explained by HPA axis dysregulation than by tired adrenal glands.
What foods support adrenal health?
Regular meals with protein, healthy fats and fiber, plenty of vegetables and fruit for vitamin C and magnesium, and limited caffeine and sugar.
Is licorice safe for adrenal support?
Whole licorice can raise blood pressure and lower potassium. It should only be used with professional guidance.
Sources
- Lopresti AL, Smith SJ, Malvi H, et al. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore) 2019. PMID: 31517876. https://pubmed.ncbi.nlm.nih.gov/31517876/
- 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. PMID: 15512856. https://pubmed.ncbi.nlm.nih.gov/15512856/
- Orentreich N, et al. Age changes and sex differences in serum dehydroepiandrosterone sulfate concentrations throughout adulthood. J Clin Endocrinol Metab 1984. PMID: 6235241. https://pubmed.ncbi.nlm.nih.gov/6235241/
- Patak P, Willenberg HS, Bornstein SR. Vitamin C is an important cofactor for both adrenal cortex and adrenal medulla. Endocr Res 2004. PMID: 15666839. https://pubmed.ncbi.nlm.nih.gov/15666839/
- Omar HR, et al. Licorice abuse: time to send a warning message. Ther Adv Endocrinol Metab 2012. PMID: 23185686. https://pmc.ncbi.nlm.nih.gov/articles/PMC3498851/
- Cadegiani FA, Kater CE. Adrenal fatigue does not exist: a systematic review. BMC Endocr Disord 2016. PMID: 27557747. https://pmc.ncbi.nlm.nih.gov/articles/PMC4997656/
- MedlinePlus: Adrenal Gland Disorders
- MedlinePlus: Stress
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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