Adrenal Fatigue
You’re told you have “adrenal fatigue.” You’re exhausted but wired. You crave salt and sugar. You rely on caffeine to function. Your sleep is broken. Your weight won’t shift. And the explanation? Your adrenals are burnt out.
The story goes like this. You’re stressed. Chronic stress overworks the adrenals, the small glands that sit on top of your kidneys and pump out cortisol. Eventually they “burn out.” Now you have low cortisol. Fatigue. Salt cravings. Sugar cravings. Weight gain. Sleep issues.
Sound familiar?
High not low Cortisol
Here’s the problem. Those are also classic low thyroid symptoms.
True adrenal failure does exist. It’s called Addison’s disease. That’s when the adrenals genuinely cannot produce enough hormone. It is rare. It is serious. It is medically recognised.
“Adrenal fatigue” as a burn-out state is not the same thing. Yet it’s often managed by adding more cortisol instead of asking why the stress system is overactive in the first place.
Most women with hypothyroidism do not have zero cortisol left. In fact, as pointed out by Ray Peat, many people with low thyroid function have elevated cortisol. In fact in menopause its clear women tend have raised levels and thats around the time HRT is recommended is it not? Moreover, administering strong showed an increase in cortisol in this study on HRT & ERT.
Why? Because when metabolism is low, your body has to compensate. Low T3 means low cellular energy. If energy production drops, the body activates stress hormones to keep you functional. Cortisol rises to mobilise glucose. Adrenaline rises to keep you moving. TSH rises to push the thyroid harder. This is not burnout. It’s compensation. I like to use the term thyroid adrenal fatigue, making it clear the thyroid is involved.
Sugar cravings but why?
As mentioned in adrenal fatigue and low thyroid function one may crave sweeter things. Yet we’ve become terrified of sugar. But low blood sugar is one of the fastest ways to raise cortisol. When glucose drops, cortisol is secreted to break down tissue and synthesise more glucose. It is catabolic. It tears down tissue to survive. If you’re under-eating, skipping carbohydrates, or living on stimulants, you are driving cortisol up further. And then we blame the adrenals. The issue is there is good sugar and processed junk combined with PUFA oils which cause the issues not sugar in of itself.
Healthy thyroid function supports healthy adrenal function. And low thyroid can contribute to what looks like adrenal insufficiency. Low T3 reduces the production of protective hormones like progesterone and pregnenolone. These buffer stress. They balance cortisol. To make those hormones, you need cholesterol. If cholesterol is low, if blood sugar is unstable, if inflammatory foods like seed oils dominate your diet, you are creating an internal environment that pushes the stress system harder. Cortisol is catabolic. It breaks tissue down. It is not a long-term solution.
Low thyroid function often leads to poor T4-to-T3 conversion. When cellular energy is low, your body does something intelligent. It raises stress hormones so you don’t become a hibernating bear, squirrel or snake. You stay functional. But at a cost. Over time, living in that stress-driven state suppresses the very metabolic hormones that should be supporting you. Progesterone drops. Pregnenolone drops. The system becomes more fragile. And instead of asking why metabolism is low, we chase the adrenals.
If your diet is already relatively clean, the deeper question becomes this. Why are progesterone, pregnenolone and other protective hormones insufficient? Is cholesterol adequate to build them? Is blood sugar stable enough to prevent repeated cortisol spikes? Are inflammatory foods quietly driving stress chemistry?
Low thyroid. High cortisol compensation. Reduced cellular energy. That is often a far more coherent explanation than “your adrenals are burnt out.”
The take-away is simple. Stop fearing balanced carbohydrates. Ensure adequate dietary cholesterol to build protective hormones. Stabilise blood sugar. Reduce inflammatory inputs. Build the metabolic foundation. Because sometimes the problem isn’t your adrenals. It’s that your metabolism has been whispering for years and no one listened.
Download my free guide to assess your metabolic health using body temperature and pulse.
I am building a course for those who want to take a guided approach with community support.
If your looking for help you can book a call to chat with me about 1:1 coaching for women wanting expert support to transform their thyroid, energy, and hormonal health.
Warmly,
Joel
References
https://pubmed.ncbi.nlm.nih.gov/9876259
Deuschle M, Weber B, Colla M, Depner M, Heuser I. Effects of major depression, aging and gender upon calculated diurnal free plasma cortisol concentrations: a re-evaluation study. Stress. 1998 Dec;2(4):281-7. doi: 10.3109/10253899809167292. PMID: 9876259.
https://pmc.ncbi.nlm.nih.gov/articles/PMC2749064
Woods NF, Mitchell ES, Smith-Dijulio K. Cortisol levels during the menopausal transition and early postmenopause: observations from the Seattle Midlife Women’s Health Study. Menopause. 2009 Jul-Aug;16(4):708-18. doi: 10.1097/gme.0b013e318198d6b2. PMID: 19322116; PMCID: PMC2749064. https://pmc.ncbi.nlm.nih.gov/articles/PMC2749064/
https://pmc.ncbi.nlm.nih.gov/articles/PMC2663529
Edwards KM, Mills PJ. Effects of estrogen versus estrogen and progesterone on cortisol and interleukin-6. Maturitas. 2008 Dec 20;61(4):330-3. doi: 10.1016/j.maturitas.2008.09.024. Epub 2008 Nov 17. PMID: 19010617; PMCID: PMC2663529.
https://www.webmd.com/a-to-z-guides/understanding-addisons-disease-basics
