One of the leading frustrations with hyocortisolism (adrenal fatigue) is the low energy. Cortisol is an important hormone for energy metabolism; influencing glucose homeostasis, and the provision of fats and amino acids from pools within the body for use as energy.
A reduced tolerance, ability to cope with, and sensitivity to stress are side effects of hypocortisolism, along with some brain fog and maybe a little depression thrown in if you’re lucky. All this signifies a decreased resilience.
The reason you may find yourself in burnout is because your body has been depleted of its reserves, which allowed you to tolerate a heavy and prolonged allostatic load (ability of your body to adapt to stress). Those reserves have been spent and therefore need to be restored in order to increase stress tolerance and build back reliance.
To support energy metabolism, mood, cognition and well-being, there are several strategic moves you can make.
Stress (through adrenaline signalling) can actually mobilise inflammatory messengers which produce inflammation. Therefore, a diet high in a wide variety of antioxidants, colours, vitamins, minerals and phytonutrients is key. One of the roles of cortisol is to quell excessive inflammation, and when it is low your diet can help compensate for this loss until cortisol normalises.
In addition, any inflammatory issues like gut dysbiosis may also drive HPA axis dysfunction. Inflammatory messengers ‘talk’ to the HPA axis and initiate the secretion of cortisol (1) .
Include whole food plants like:
- Whole grains like quinoa and brown rice
- Nuts and seeds like almonds and sunflower seeds
- Dark leafy greens like spinach, arugula and romaine
- Cruciferous vegetables like broccoli & cauliflower
- Berries like red grapes and blueberries
Additionally, these foods are rich in what are known as ‘co-factors’ which help drive the pathways which produce your energy. Magnesium for example is a key addition in glycolysis, the first step by which energy is drawn from glucose in foods like brown rice.
Also, higher levels of quality protein will help to restore the pool of amino acids depleted from chronic stress. This subsequently supports turnover of key hormones, neurotransmitters, antioxidants, enzymes, immune cells and tissues, like muscle.
Notably, animal protein is an essential part of the recovery process for ‘adrenal fatigue’ (2), perhaps due to the complete and concentrated amino acid profiles of meat, fish and organ meats.
It has been reported that a vegan diet may be insufficient at providing a remedy for even mild cases of adrenal fatigue (2) (need for higher than usual protein requirements). That may not be the case for everyone, but its an interesting observation.
Quality fats from fish and plants are an essential component for cellular communication and health, and will subsequently help support good energy, mood and cognition:
- Olive oil
- Fatty fish like Sardines, Herring, Salmon
- Cold pressed seed oils
Any processed and refined foods are an added stressor to the body. Try to eliminate these completely.
Blood sugar control
This is an important consideration when it comes to burnout recovery, and is especially related to caffeine, sugar and refined carbohydrates.
Dips in blood sugar (after spikes) engages cortisol to re-establish blood glucose levels. Excessive consumption of sugary and caffeinated items instruct large fluctuations in blood sugar, mobilising cortisol.
On a daily basis, these fluctuations can really add to the allostatic load (straws on camels back), and compound with life stressors that also stimulate cortisol.
Therefore, whole grain, unrefined, fibrous carbohydrates are a good option to keep blood sugar stable throughout the day. In addition, try to eat square, regular meals to ensure cortisol doesn’t have to mobilise any fuel from reserves (because you haven’t eaten in a while).
Try not to eat too long after the sun goes down, and definitely not after 10PM. As we will cover further down, sleep is an essential factor to optimise in HPA recovery.
Synchronisation with circadian rhythms is a must. Regularly consuming foods outside of light and day cycles can instruct a mismatch between your internal body clocks, which talk to the HPA axis – it is under circadian control.
Therefore, late night eating can affect your sleep, and cortisol secretion as a result the next day.
Find out more about late night eating here.
In addition to nutritional support, a little therapeutic movement can also go a long way.
This is like walking a tightrope, because a little can actually be beneficial, but overdo it and its back to square one. The idea here is to start to re-build your resilience by increasing metabolic reserve.
Metabolic reserve is technically the capacity of your cells, tissues and organs to withstand continuous changes to physiological needs. That basically means their ability to withstand stress.
In cases of severe burnout, the best place to start is with mentally and physically calming and strengthening exercises such as Yoga, Qi Gong and Tai Chi.
These are brilliant because they give you a leg to stand on. As mind ~ body practices, they help cultivate vital energy and start to build back your resilience. Spending as much time as you can in a relaxed state is key to regaining your strength. That also means less time spent in fight or flight mode – aka sympathetic stimulation.
Focused breathing coupled with fluid movements help induce flow states, which change the chemistry of your mind and body, inducing a relaxation response that supports the recovery process (3)
You can think of Qi Gong as a moving meditation, a way to get lost in the sensation of effortless flow.
Qi gong has been shown to reduce stress (4), improve well being (5) and physical health (6). Notably its also been found to normalise cortisol through better HPA control (blunting cortisol responses to stress) (7).
A more physical form of moving meditation is yoga. Depending on which type of yoga you practice, it can bring the mind and body into a state of union, flow, equanimity and harmony.
Again, its like a moving meditation, with as much of the practice training you mentally as well as physically.
Yoga has been studied with some very encouraging findings to share, including:
- Normalising cortisol levels (8).
- Raising Serotonin neurotransmission (9).
- Reducing stress and improving well being (10).
- Decreases fatigue (11).
- Lowering sympathetic nervous system activity whilst increasing parasympathetic (relaxation state) (12).
Again, Tai chi is a form of gentle calisthenic aerobic activity which is coupled with deep and focused diaphragmatic breathing.
Like yoga and Qi gong, Tai chi is fantastic for inducing the relaxation response and states of flow, through fluid and circular movements.
This review concluded that Tai Chi may have a beneficial impact on HRV (15) (although the sample size was small, the preliminary results are still promising).
Think of the heart and nervous system as an elastic band – more resilience having more elasticity and able to return back to normal after being stretched. Less resilience being less elastic. Thats basically heart rate variability in a nutshell.
HRV is a very good measure of autonomic nervous system activity (16), ie how stressed you are and how much resilience you have as a result.
This is a more demanding form of exercise and will expose you to stress (eustress), and can be incorporated after a good stretch of mind/body practices.
Your type of exercise depends largely on were you are at on the HPA dysfunction scale and how much reliance you have left/built up.
Eustress can actually be good, and is what allows you to become stronger as a result of exposure in controlled amounts. This process is known as hormesis.
Weight training is a great example here because its incredibly beneficial in recovering from burnout. Thats provided you keep an eye on intensity, duration and volume of training.
Weight training can be beneficial for some people, especially after muscle loss from chronically elevated cortisol in the hypercortisol phase of stress.
Increasing your muscle mass can do wonders for your health, particularly in regulating your metabolic health, posture and general well being through greater strength and co-ordination.
The hormonal benefits of weigh training, and paradoxically the cortisol released through resistance training can actually have the opposite effects to that released from psychological stress. That is increased mood, cognition, memory and ability to cope with stress (17).
Chong Chen Shin Nakagawa Yan An KokiIto Yuji Kitaichi Ichiro Kusumi. The exercise-glucocorticoid paradox: How exercise is beneficial to cognition, mood, and the brain while increasing glucocorticoid levels. 2017.
Lifting heavier weights for fewer repetitions may be less stress than HIIT and interval training, as these put a large amount of stress on the nervous system.
Recovery is arguably a more important factor than the training here. This is where the adaptations occur, in the recovery phase in response to training. Its imperative that you are well fuelled before and after training, get a good nights sleep and minimise other stressors around recovery.
Without a good recovery process, its easy to end up back where you started (18).
Building up your reserves is essential to increasing your tolerance for stress once again. In these times of recovery, requirements for extra nutritional support are high.
You could think of this as a period in which you need to stockpile resources for later use. Not only do you need to make sure you support daily functioning, you need more to get back to full strength.
In this case, supplements can be very helpful to provide a bridge from burnout to recovery.
B Vitamins serve as essential drivers of energy metabolism, tissue repair and in the HPA cascade, affecting adrenal function.
A combined B Vitamin might be best as they work synergistically when combined. The relative abundance/scarcity of one of more B vitamins affects the way the others work, so taken together ensures against offsetting the action of one another.
Since stress affects digestive function, some support may be needed in this area to assimilate the nutrients from the foods you are eating.
- A good quality Probiotic
- Apple Cider Vinegar
- Digestive Enzymes – Herbs, spices, teas
- Establishing and eliminating food intolerances
Adaptogens are also a brilliant way to support homeostasis of the HPA axis, to regulate cortisol and to provide you with good energy.
These plants are wondrous allies in the building of resilience and tolerance to stress acutely and overtime. Their most notable characteristic is their support of energy production.
In addition, they provide an elevation in mood, cognition and even sleep.
- Ashwagandha – find out more here
Apps to help stay on top of sleep and stress
- HRV 4 Training
- Sleep Cycle
Thats right folks, its time to get stress under control. This is undoubtedly the most important part of recovery, because its limey the most common source of stress for most of you.
Arming yourself with ways to defuse the stress response is key, because lets face it – todays lives are full of stress, its practically impossible to avoid.
In addition, your personal response to and perception of stress is crucial here. What sets you off is very unique to you, and you may have to do a little mental reshuffling to change how you react to stress.
Lets use someone with social anxiety as an example, and assume they still expose themselves to regular social interactions. Socialising will engage their stress response, and HPA axis and the situation will reveal itself as a stressful one.
Unless this person changes their perception of the situation to a less threatening one, its going to be hard to fully recover. Its the same situation for someone who lets their boss stress them out, or is in a knot about finances. Luckily, there are a few ways of defusing these:
- Meditation – slowing down, tuning into you and chilling out regularly helps induce structural changes to your brain, and reduce stress
- Breathing – brings balance to the autonomic nervous system
- Nature walks – nature is calming
- Mindfulness – becoming aware of what stresses you out, why, and how you can look at stress from other perspectives.
- CBD – Cannabidiol can actually help defuse the HPA axis response to stress.
- CBT – mental reshuffling of thoughts, cognitions and emotions that produce stress.
- Social time – time with friends, family and romances help to induce better autonomic control and reduce stress.
- Laughter – speaks for itself.
- Good for me/Bad for me list – note all the things that make you feel alive, happy and joyous. In another column note the things that drain you, make you feel bad and unhealthy. Prioritise the items in each column from most to least influential. Then write out a plan to maximise the items on the good column while decreasing/eliminating those on the bad side. *
*A great strategy taken from a practitioner who has helped patents recover from adrenal fatigue (19)
The HPA axis, as well as being aroused by stress, is also under the influence of your master circadian clock. This clock is housed within the hypothalamus and is called the suprachismatic nucleus (SCN for short).
Light/dark inputs, and the rhythms of night and day affect the master clock, and subsequently your peripheral clocks in organs and tissues, via the autonomic nervous system (20).
The master clock is what enables appropriate regulation of melatonin, cortisol and other hormonal secretions which enable you to sleep well.
Therefore, late nights, exposure to light in the evening and poor sleep disrupt the HPA axis, and make it more difficult to build back your resilience.
To optimise your recovery, tune into the rhythms of day and night. Expose yourself to light first thing in the morning, and for at least an hour though out the day. Show some skin! Its important to expose your skin to the sun to soak up enough UV for Vitamin D synthesis.
- Minimise artificial light in the evening by using f.lux for devices. Ideally don’t look at screens/devices for a couple hours before sleeping.
- Take naps to top up on sleep you may have missed during the night. Studies have shown that topping up on missed sleep during the day can help reduce ‘sleep debts’ (21).
- Use calming herbs to induce deep, restful sleep. Have a cup of rooibos, chamomile or lavender tea. Lavender essential oil can be good as well.
- kava Kava, Cannabis and Valerian root are also tremendous for inducing a deep sleep. My favourite has to be cannabis.
- Ensure your room is well ventilated with fresh and circulating air, and is at a comfortable temperature. The master clock also responds to overly high or low heat, and can subsequently affect your sleep though its hormonal signalling (22).
- Start to develop and evening routine which helps you wind down progressively and slowly. It no good jumping into bed just after you have finished racing around in the evening. Read a book, do some stretches, do some breathing – relax before going to sleep.