Your Adrenals: A Key to Total Wellness

By: Mary Shomon, Thyroid Expert

Average read time: 4.5 minutes

When you look into improving thyroid health, you hear about the adrenal glands quite frequently. What are the adrenals, and why do they often seem to go hand in hand with the thyroid when we’re focusing on ways to feel well? Let’s take a look.

What Are Your Adrenal Glands?

Your adrenal glands are two small, bean-shaped glands that sit atop your kidneys. They have an important job: to produce the hormones your body needs to function and manage ongoing and short-term stress. The two key hormones your adrenals produce are cortisol and adrenaline. Cortisol is released each day in a cycle – the highest levels should be produced overnight and in the morning, with a steady drop during the day, reaching the lowest level around bedtime. Adrenaline is the ‘fight or flight’ hormone that is released during periods of acute stress or danger.

The adrenal glands can be the target of an autoimmune attack. On one end of the spectrum is Cushing’s Disease, where your adrenals produce far too much cortisol, which can cause weight gain, puffiness, and variety of other health problems. On the other end of the spectrum is Addison’s Disease, where your adrenals become unable to produce cortisol, a life-threatening condition that leaves you open to infection. There are conventional drug treatments for these two extreme conditions.

More common, however, is a dysfunction of the adrenal glands somewhere in between. For example, you can have:

Signs of an Adrenal Imbalance

The following chart shows some of the more common characteristics and signs of high or low cortisol:

Overactive Adrenals/High Cortisol Underactive Adrenals/Low Cortisol
  • You can’t fall asleep
  • You can’t stay asleep
  • You can’t get up
  • You don’t feel refreshed after a long sleep
  • You are on the go, always busy
  • You feel ‘tired but wired’
  • You are often exhausted and tired
  • You’re a type A
  • You can be short-tempered
  • You are prone to anxiety and panic attacks
  • You seek out conflict
  • You can’t cope with everyday stress
  • You feel overwhelmed
  • You feel slightly depressed
  • You avoid conflict
  • Your thoughts are always racing
  • You can’t focus
  • You feel mentally ‘brain-fogged’
  • Your thinking and memory are fuzzy and slow
  • You tend to eat at night
  • You have cravings for salty and sugary foods
  • You crave carbohydrates when you’re tired
  • You overuse caffeine
  • You have higher blood pressure
  • You have lower blood pressure

Signs That Your Adrenals Aren’t Working Properly

Some other signs that your adrenals aren’t working properly include:

Testing for Your Adrenals

Conventional testing for the adrenals is looking for Cushing’s or Addison’s Disease – not an adrenal imbalance. Common testing includes a one-time morning cortisol test from blood work or a 24-hour urine collection to measure urinary cortisol. The problem with this testing is that the one-time blood test only shows what’s going on at that moment. Cortisol could appear normal in the morning, but be irregular the rest of the day. And the 24-hour test just shows how much cortisol is released, not if it is being released in the appropriate daily pattern.

This is why integrative physicians who specialize in adrenal health recommend the 24-hour cortisol saliva test. With this home test kit, you collect your saliva six times: in the morning, mid-day, mid-afternoon, dinnertime, bedtime, and middle of the night. The results are then plotted on a curve, to evaluate dysfunction at any point during the day. Most integrative doctors use this test. In many states, you can also order a test kit yourself from a ‘direct-to-consumer’ laboratory.

Supporting and Balancing Your Adrenals

If you have significantly low cortisol, integrative physicians may prescribe a short course of a low dose of bioidentical cortisol, known as hydrocortisone (brand name Cortef.) This is a usually a short-term measure to help support your adrenals while you address other significant factors and rebalance your adrenals.

It’s also important that other hormonal imbalances are addressed. It’s not enough to only address your adrenals and your thyroid. You also want to make sure that your estrogen, progesterone, testosterone, DHEA, and pregnenolone levels are balanced. Prescription medications, supplements, and changes to diet can help balance them.

There are a variety of supplements (see Note) that can help address adrenal imbalances. But here’s a caution: managing adrenal imbalance is not a do-it-yourself project. You can make things worse by taking the wrong supplement at the wrong time. Work with a knowledgeable practitioner to come up with a plan to incorporate adrenal-friendly supplements.

When it comes to diet, there are several ways to reduce physical stress and support your adrenals. Start by lowering the toxic stress of the food you eat by reducing or eliminating hormones, pesticides, grain-fed meats, genetically-modified foods, processed foods, sugar, artificial sweeteners, and gluten. Make sure to also drink lots of clean water, and get enough fiber each day (ideally 30 grams or more). And when you are eating, don’t multitask. Put away the phone and turn off the television. Eat slowly, chew thoroughly, breathe deeply, and focus mindfully on your meal.

One of the most important things you can do is to get enough sleep. Sleep is when our hormones rebuild and is a foundation of adrenal health. Aim for seven or more hours of quality sleep per night.

Another element of effective ‘adrenal rehab’ is to incorporate active stress management into your life. This means a regular daily practice that helps lower your heart rate, respiration rate, and cortisol levels. Figure out which approaches work best for you (from the three key types of stress-busting activities below) and do them daily:

Movement and exercise is another important part of adrenal support, but with a caution: Don’t overdo it. If your adrenals are imbalanced, that 90-minute intense spinning class or 10-mile run are likely to stress your adrenals further and worsen your imbalance. Focus on gentler exercise that is lymphatic (like walking, hiking, rebounding, or swimming) and doesn’t leave you exhausted and recuperating for days.

Another crucial part of supporting your adrenal glands is making significant changes to your attitude and lifestyle. Here are some tips:

Finally, if you need some extra support, consider getting professional help. Counseling and therapists can help you learn to better manage your stress, and there are experts and classes to help you effectively master relaxation and stress-reduction techniques.


Note: Always consult with your health care practitioner before incorporating supplements, as there may be risks such as drug interactions.

up next: How to Avoid an Exercise-Induced Symptom Flare-Up


About the Author

Mary Shomon is a patient advocate and New York Times bestselling author of 13 books on health. Mary has been researching, writing and teaching about thyroid disease, hormonal health, weight loss, and autoimmune disease for two decades. In addition to her books, you can find her writing at and, and catch her PBS Healthy Hormones television specials. Follow Mary on Facebook.