adrenal fatigue adrenal glands what are the adrenal glands

Adrenal Fatigue or HPA Axis Dysfunction

What is Adrenal Fatigue?

Are you a type A personality? A high achiever? SuperMom? People wonder how you can manage to do so much in a day or do so many things so well? Are you under lots of stress? You may be at risk of or are already experiencing signs of adrenal fatigue, also known as HPA axis dysfunction. Adrenal fatigue is a condition where your adrenal glands appear to not be working properly.  It may be that the gland is lacking vital nutrients.  It may be that it is not receiving the correct messages from your pituitary.  The pituitary is the master gland in your brain that tells the others what to do. The hypothalamus, another gland in your brain, works together with the pituitary to regulate all of your organs.

What are the adrenal glands?

Never heard of the adrenal glands you say?  Well, you’re not alone, 90% of the patients that I see with adrenal fatigue have never heard of them either. Why is that?  Because the adrenal glands are one of the most overworked yet also overlooked glands in your body. They are equally important as the other endocrine glands, like your thyroid and your ovaries, but they are largely ignored.

Your adrenal glands sit atop your kidneys and perform a variety of functions, mainly those that relate to stress.  The adrenal glands secrete a variety of hormones that regulate:

  1. Your blood pressure
  2. Cardiovascular functions such as your heart rate
  3. Immune response and inflammation
  4. Sex hormones
  5. Your blood sugar
  6. Sympathetic nervous system – the part of the nervous system that prepares you to fight or run when you are in danger
  7. Parasympathetic nervous system – the part of the nervous system that helps you relax, rest, and digest your food

What are the symptoms of adrenal fatigue or HPA axis dysfunction?

  1. Tiredness, despite adequate sleep
  2. Insomnia or sleep difficulties, particularly waking throughout the night
  3. Hypoglycemia (drops in blood sugar) if you don’t eat regularly
  4. Feeling weak, shaky, irritable or lightheaded if you don’t eat regularly
  5. Hormonal imbalance or infertility
  6. Anxiety or inability to cope with stress
  7. Poor digestion or irritable bowel syndrome
  8. Allergies, asthma, eczema
  9. Inflammatory or auto-immune conditions
  10. Mood disorders including depression and bipolar disorder

What are adrenal gland tests?


DHEAs is a weak male-type hormone or androgen that your adrenal glands produce. It is a building block for testosterone and in turn, estrogen.  It also helps with energy and libido. It acts to moderate estrogen. It can be measured by a blood test.


Testosterone is a stronger male hormone that your adrenal glands produce.  It helps with energy, drive, motivation and libido and is also a building block for estrogen.  It can be measured by a blood test.


This blood test is usually drawn in the morning around 8-9 a.m. and in the evening around 6-8 p.m.   Or, you may collect a saliva sample for cortisol at 4 points throughout the day.  Cortisol is a hormone secreted under stress.  Excess cortisol can cause weight gain.  But, you need to have enough cortisol for normal conversion of fat, protein and starch to energy and for normal blood pressure.


Aldosterone is a hormone that helps to manage salt and water balance and regulate your blood pressure.  A blood test can test your aldosterone level.


Adrenocorticotrophic hormone (ACTH) is a hormone released by your pituitary that helps to stimulate your adrenal glands.  A blood test can check your ACTH level.

Natural treatment for adrenal gland problems

Not surprisingly every culture has their own herbs for the adrenal glands, also known as adaptogens.  These are herbs that help your body adapt to and deal with stress more easily. Well-known adaptogens include ginseng, rhodiola, ashwagandha, schisandra, and skullcap. In addition to helping support the adrenals with adaptogens, I always recommend replenishing the nutrients that are most important for normal adrenal gland function: vitamin C, vitamin B5, vitamin B6, zinc and magnesium.

What are the benefits of natural treatment for your adrenal fatigue?

  1. Better energy
  2. Better ability to cope with stress
  3. Less anxiety and depression
  4. Better blood pressure
  5. More stable blood sugar
  6. Reduced inflammation
  7. Better hormone balance
  8. Improved digestion
  9. Better mood

Book an appointment here or call the office for more information at 416-481-0222.

Authored by Dr Pamela Frank, BSc, ND

Adrenal Gland and HPA Axis Research

Bipolar disorder is associated with dysfunction of HPA axis activity, with important pathophysiological implications. Targeting HPA axis dysfunctions might be a novel strategy to improve the outcomes of bipolar disorder.

Psychoneuroendocrinology. 2016 Jan;63:327-42. doi: 10.1016/j.psyneuen.2015.10.014. Epub 2015 Oct 21.
The HPA axis in bipolar disorder: Systematic review and meta-analysis.
Belvederi Murri M1, Prestia D2, Mondelli V3, Pariante C3, Patti S2, Olivieri B2, Arzani C2, Masotti M2, Respino M2, Antonioli M4, Vassallo L2, Serafini G2, Perna G5, Pompili M6, Amore M2.

Neuroendocrine studies have demonstrated HPA axis overactivity in major depression, a relationship of HPA axis activity to cognitive performance and a potential role of HPA axis genetic variation in cognition.

Mol Psychiatry. 2017 Apr;22(4):527-536. doi: 10.1038/mp.2016.120. Epub 2016 Aug 16.
HPA axis in major depression: cortisol, clinical symptomatology and genetic variation predict cognition.
Keller J1, Gomez R1,2, Williams G3, Lembke A1, Lazzeroni L1, Murphy GM Jr1, Schatzberg AF1.

Depression, anorexia nervosa and obstructive sleep apnoea, are associated with cortisol rhythm phase shifts and increased cortisol exposure. Higher nocturnal cortisol exposure is observed in patients with Cushing’s syndrome and adrenal incidentalomas with autonomous cortisol secretion and is associated with insulin resistance, and increased cardiovascular risk and mortality. A decrease in cortisol rhythm amplitude is seen in adrenal insufficiency, and despite replacement, patients have an impaired quality of life and increased mortality.

Best Pract Res Clin Endocrinol Metab. 2017 Oct;31(5):459-473. doi: 10.1016/j.beem.2017.10.011. Epub 2017 Nov 2.
Human studies on hypothalamic-pituitary-adrenal (HPA) axis.
Liyanarachchi K1, Ross R2, Debono M3.

Adrenal Fatigue
Article Name
Adrenal Fatigue
Adrenal fatigue or insufficiency is not a disease, but rather suboptimal adrenal gland function, usually caused by high stress. Supporting adrenals helps.