Adrenal Fatigue Series: Part 2 – Testing and Treatment

Read the first post in this series here: Adrenal Fatigue Series: Part 1 – What is it and do YOU have it?

After that day in the doctor’s office when my saliva test results came back with high cortisol, I knew I had to make lowering it my number one priority.  Not only was I on the verge of it getting much worse, but it was effecting so many other aspects of my life and health.  My other hormone levels were suffering…enough for the doctor to point out that I had the ‘estrogen of a menopausal woman’.  My clients were noticing my lack of energy during their fitness sessions.  My own workouts were minimal at this point, as I was unable to muster the energy and strength to get through much more than a walk outside.  And like I said in the previous post, my sleep was a mess.  I was struggling.  

I needed to lower the stress load on my body immediately.  Myself and my body were already dealing with enough trying to heal post-salmonella and ulcerative colitis flare.  I couldn’t add any more fuel to the stress fire.  And so, just like that, my lifestyle drastically changed.  I joined a yoga studio and committed to going to at least 3 classes a week.  I signed up for a guided meditation app on my phone and started meditating nightly before bed.  I added Epsom salt baths to my nightly regimen to not only de-stress but also assist my body in detoxifying and take some stress off my liver.  I took coffee out of my morning routine and all sugar and alcohol out of my diet.  I forced myself to stop working past 7:00pm and just sit and relax.  I added midday walks to take a break from work.  

Now, only 4 months since installing all of these new lifestyle routines…I am well!  I sleep great every night and wake up rested.  I don’t need caffeine to get me ready for the day.  I have constant energy, even through busy days and good workouts.  My digestive and endocrine systems are getting back to regular function.  It feels so good to feel normal!  

Can you relate to my story?  Do the list of signs, symptoms, and lifestyle factors in the last post sound like you?  Now what?  

How do you test for adrenal fatigue?


Simple At-Home Test – Iris Contraction*:  

This is an easy test you can do right at home with only a bit of equipment.  You will need a mirror and a penlight or small flashlight.  Position yourself closely in front of a mirror in a very dark room.  Turn on the flashlight and position it about 6 inches away from the side of your head.  The light should be shining at your ear.  Slowly, bring the light around so it shines at a 45 degree angle into your eye.  DO NOT LOOK DIRECTLY AT THE LIGHT.  Stay looking straight ahead at your eyes in the mirror.  As soon as the light hits your eye, begin counting.  Notice what happens to your pupil as the light shines in it and hold it for a count of 20.  A normal pupil will constrict and hold.  In those with adrenal fatigue, the pupil will not be able to stay contracted for any length of time and may either ‘pulse’ or lose the hold altogether.  Measure your results as follows:

  • EXCELLENT – Pupil constricts and holds tight for 20 seconds.
  • FAIR – Pupil holds, but pulses after 10 seconds
  • POOR – Pupil pulses and becomes larger after 5-10 seconds
  • FAILURE – Pupil pulses and becomes gradually larger over the first 10 seconds
  • EXHAUSTION – Pupil immediately becomes larger or fails to constrict
*Do not perform this test if you have had recent eye surgeries, head injuries, or wear colored contacts. 


Hormone Lab Tests

To get a more accurate and official diagnosis, you may consider lab testing for adrenal fatigue.  While your medical professional may order tests using blood, urine, or saliva, it has been pretty widely determined that the saliva tests are the most accurate.  These tests use saliva to measure the amount of cortisol streaming throughout your body.  The best tests are those that capture the measurements at intervals throughout the day; morning, noon, evening, and bedtime.  Our cortisol levels change throughout the day — high in the morning with a gradual decline throughout the day until getting very low at bedtime — so the periodic measurements can show any variance in the normal cortisol decline.  A lot of these saliva tests will also measure other hormone levels as well in order to get a better read of how far along you are in the adrenal fatigue decline.  By testing the levels of pregnenolone, testosterone, progesterone, and estrogen, it can be determined if the stress hormone production has ‘stolen’ nutrients from the other sex hormones in an attempt to keep the cortisol levels pumping.  

It is important to get this test ordered from a knowledgeable health care provider who can interpret the results appropriately.  While many medical doctors may not order these tests for you, a Naturopath or Integrative Doctor frequently use them.  


So, it’s official.  Your cortisol is high, your adrenals are running on empty, your sex hormones are struggling…

How do you treat adrenal fatigue?


1.  Eliminate ‘stressful’ foods.  

While food can be incredibly healing medicine, the wrong foods can just as easily be devastating to your health.   These ‘stressful’ foods increase inflammation in the body and digesting them takes energy away from the healing process.  The foods that you are allergic, intolerant, or sensitive to are YOUR ‘stressful’ foods.  They are going to be different for everybody and it is very important for you to find yours.  The best way to do so is to go on a 28-day elimination diet.  In this diet, you will be eliminating all potentially stressful and inflammatory foods from your diet for a period of time, letting your body heal, and then slowly introducing them in a controlled manner — one food at a time, allowing 3 days to notice a reaction.   By reintroducing them in this way, you will be able to see clearly how your body reacts to specific foods and whether they agree with you or not.  From there, you can create your own ‘avoid’ foods list and keep them out of your diet until you are fully healed.    The foods to be eliminated are: dairy, grains, refined sugars, refined flours, highly processed oils, and legumes.  Don’t freak out!  This is temporary and an important step in the journey.  

What I did:  While I already follow a paleo diet, I also took out nuts and seeds because I know that I do not always do well with them.       

2.  Eliminate stimulants — caffeine, alcohol, and sugar have to go.

This going to be a hard one for a lot of people but also a non-negotiable to lowering your cortisol and allowing your adrenals to heal.  When blood sugar levels get out of control, cortisol is called in to help the situation, so it is imperative to avoid this situation entirely.  That means sugar intake needs to be kept to a minimum.  This doesn’t just mean candy and baked goods.  The high sugar content in some fruits, fruit juices, packaged foods, sports drinks, and many meal replacement bars and shakes are out too.  Caffeine stimulates the adrenals in much the same way as a stressful ‘fight or flight’ reaction, so all caffeinated drinks, including your morning cup ‘o joe must go.  Alcohol puts both of these issues into one glass.  The extremely refined form of carbohydrates causes a high spike in blood sugar levels AND forces your body to produce energy at a rapid rate.  Two body mechanisms that call on cortisol in a major way.  

What I did:  I gave up wine, coffee, and sugar…3 of my favorite things!  This was very tough, but so necessary.  I noticed immediate improvements when these three stimulants were out of my life.  

3. Identify and eliminate stressful people, situations, and surroundings.

Another hard one.  I understand that it’s impossible to remove yourself from all stressful life events, but it IS possible for them take less of a toll on you.  First, identify those people, places, and things that rob you of your energy.  What people/surroundings in your life leave you feeling drained, depressed, frustrated, angry, or tired?  It may be a casual acquaintance, coworker, boss, loved one, or friend.  Anyone that increases your stress level or takes away your energy needs to be put on the back burner while you heal.  If it is someone that can easily be avoided during this time, then just make the effort to steer clear of them.  If it’s someone like a boss or loved one that can’t be avoided, then take yourself out of the equation as soon as the conversation gets to be too much.  If it’s someone you can comfortably talk to, then explain that at times you may need to end the conversation short in order to keep your stress levels low.  

What I did:  Because I am single without children AND work for myself, I really don’t have people in my life that are stressful.  But, I do have stressful situations that come up from my job.  While I couldn’t get rid of these situations, I instead had to really focus on how I was reacting to these stressors.  Instead of letting myself react and stew on them, I had to reframe my reaction and realize I wasn’t going to change the outcome by overanalyzing.  I also constantly reminded myself that my health was more important than __________ .(insert stressful situation here)

4.  Focus on sleep.

If you do not make it a priority to get at least 8 hours of high quality sleep a night, you will not recover.  Bottom line.  This can be a challenge when your cortisol levels are taking over and falling asleep seems impossible.  If this is the case, you need to take active steps to become relaxed and calm before bed.  Need some ideas?  Turn off all electronics one hour before bed (that includes your phone!), meditate just before or after turning the lights off, take an epsom salt bath before climbing into bed, use only candlelight as you get ready for bed.  Bridge the gap between LIFE and SLEEP!    

What I did:  This was a big one for me.  My mission was to get back to good sleep, so I did it all.  I turned off all electronics and lights at 8:30pm, took a bath by candlelight, then got into bed and meditated.  What a difference!  The best lifestyle changes I have made so far and something I still do nightly.

5.  Workout…but not too hard. 

While exercise has been shown to regulate cortisol, insulin, growth hormone, and many other hormones in your body, physical stress can also be a major factor in contributing to adrenal fatigue, so finding the perfect balance is critical during this time.  Find a form of exercise that is enjoyable and lifts your mood.  It should be something that gets your body moving, your heart pumping, and your muscles fatigued.  It should NOT be grueling, excruciating, competitive, or exhausting.  Walking, weight lifting, swimming, dancing, and biking are all great activities and even better if you can do them outdoors in the sun and fresh air.  These workouts should make you feel alive again, not even more depleted.  If your exercise routine ever begins to make you feel worse, cut back for a few days to rest and try again.   

What I did:  I traded in my heavy weightlifting workouts for yoga, walks outside, and bodyweight strength movements like squats, pushups, and sit-ups.  

6.  Connect your mind and body to your breathe — yoga, tai chi, meditation.

This is a topic that comes up a lot in the health world and there’s good reason for it.  These activities teach you how to connect with your inner self, perhaps without you even realizing it.  By using the breath to connect to your body and its movement, you are also learning how to focus internally and rest there, letting your thoughts go, which in turns gives your mind a break from thinking, reacting, wondering, planning, and worrying.  When our minds are constantly in this active state, it is impossible to relieve stress.  Even if you’re laying down, watching television, taking a bath, or anything that appears to be relaxing, if your MIND isn’t calm, it’s not going to be effective. 

What I did:  Not only did I begin doing yoga, but I committed to a 4-time a week routine.  I also made the effort once in class to really focus on the internal aspect instead of just going through the movements.  Such a great feeling!

7.  Add superfoods daily.

The superfoods for adrenal health are the same superfoods that are healing for all other conditions…and they cannot be overlooked.  You will need to include as many of these as you can every single day.  They contain essential nutrients that are depleted from the body when under a state of stress.  They also act as healing agents for the digestive system, the endocrine system, and blood sugar regulation. They are:

What I did:  All of the above…everyday.  Do it.  It’s the key to success.  

8.  Support the process with supplementation.

While I a firm believer that food should always come as a first line of defense to get necessary nutrients, sometimes a little extra help is needed in cases of illness.  Those that are dealing with adrenal fatigue made need a little extra nutritional support during the healing phase, especially because compromised digestion almost always coincides with adrenal fatigue.  Since nutrients are not being broken down and assimilated correctly, many vitamins and mineral levels will come up short.  Most of these can be addressed and remedied by including the superfoods listed above, but there are still some key nutrients to focus on.  Getting your mineral levels balanced will help with energy levels and the sleep-wake cycle.  Magnesium, sodium, potassium, and calcium are all important during this time.  In an effort to  aid the digestive process, HCL supplementation may be a good idea.  Read my post about this topic and implement it while healing.   A high quality probiotic will also be helpful.  Look for one that has some diversity with at least 5 different strains of bacteria.  There are also some herbal supplements that have been used for centuries in their native cultures to treat illnesses such as adrenal fatigue.  These include ashwagandha, ginseng, licorice root, and maca.  These herbs all have a positive effect on maintaining proper cortisol levels and energy production.   

What I did:  I had great success with an ashwagandha supplement and highly recommend it. I also took a supplement called Tri-Salts that is a mix of potassium, magnesium, and calcium as well as salting my food with Himalayan sea salt for proper mineral balance.  I drank licorice root tea daily and still do because I love it.  I supported my digestion with Betaine HCL until my body relearned how to do it on its own.  

9.  Eat frequently.  

In order to keep your blood sugar levels stable throughout the day so as not to trigger a cortisol response, it is better to eat smaller meals more frequently throughout the day instead of larger meals spread far apart.  Aim to eat a meal consisting of high quality protein, carbohydrate, and fat every 2-3 hours.  Don’t let yourself get to the point of intense hunger. 

What I did:  I allowed myself to eat when I wanted to, which for me was about every 3 hours.  


10.  Find enjoyment in life!

Do something everyday that gives you sheer pleasure!  Talk with friends, enjoy nature, get some sun, watch a movie, or listen to your favorite album.  Break the mentality that relaxing and spending time on yourself is a luxury that you don’t need or deserve.  Instead, realize that it is an imperative part of your recovery and something to enjoy everyday!

What I did:  I made an effort to have dinner with a friend at least once a week.  I also made myself put down my work every night to relax and enjoy my favorite TV shows instead of working right through them like I usually do!  I spent a lot of time in the kitchen cooking, something that is both fun and therapeutic for me.

Consider these 10 action items like rungs on your ladder to health; if any one of them is missing, then you won’t make it all the way to full recovery.  These are all important steps in the process and must become a part of your lifestyle during this time.  You can do it!  And the feeling of getting your energy, health, and vibrancy back to what it once was will be well worth it!

Are you currently experiencing high cortisol/adrenal fatigue?  Have you healed yourself?  I want to hear from you!  Email me at



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