Tips & Advice

From Dr. Liz Herself

September 3, 2018
Support Your Adrenals
Tired Low Cortisol Woman

Fall is falling, the days are getting shorter. My “baby” is now 17 years old and has started his senior year of high school. Quiet Summer is in my rear view mirror and a busy Fall is now in full swing.

Nowadays, “busy” easily spills over into “stress”.

Our adrenal glands keep us going under stress, and they can get tired. There are entire books written about adrenal fatigue, so here I will focus on cortisol, a.k.a. the stress hormone.


The adrenal glands are small but mighty. Each one is about the size of a walnut and sits on top of a kidney. They make many steroid hormones, including adrenaline, androgens, and corticosteroids. Cortisol is the active form of the corticosteroid group of adrenal hormones. Cortisol is anti-inflammatory and regulates metabolism. When we are under stress, our adrenals make more cortisol. Cortisol causes the release of sugar into the bloodstream, in preparation for the “fight or flight” that might have to happen next. The problem is that nowadays many people’s bodies are in a constant state of “fight or flight” readiness.

Adrenal Fatigue

Many people are aware of the effect of too much cortisol causing weight gain. However, in my practice I see so many people under chronic stress; they have trouble with their metabolism even if their cortisol level is not elevated. This is where we start to see adrenal fatigue. We measure cortisol as a fasting blood level first thing in the morning. Another way to measure cortisol is with saliva testing; a saliva cortisol testing kit can allow a person to measure their cortisol four times throughout the day – early morning, noon, afternoon and late evening. Because medical insurance usually does not cover the saliva testing, I don’t order it that often. Many times my patients will have had it done elsewhere, and I will see a clear correlation between their results and the symptoms they describe to me. Cortisol is at its highest level when we wake up, and steadily decreases throughout the day. This means that while we are sleeping, our adrenals are busy in the early hours of the morning making cortisol and getting us ready to have the energy for our day. If someone has early morning waking or feeling sweaty in the early hours of the morning, they might be making too much cortisol. This is often the case if they are under particular stress. In this situation, the adrenal glands can benefit from support from herbal “adaptogens” – ingredients that improve adrenal function over time. There are also over-the-counter ingredients such as phosphotidylserine (often called “PS”) and L-theanine that can help calm that excess early morning production of cortisol.

Adrenal Support

Adrene ViveWith our busy stressful lives, it’s good to use some kind of adrenal support supplement. Some boost energy and some have a more calming effect. It is perfectly safe and acceptable to use these kinds of supplements on an as-needed basis. I take an adrenal boosting supplement on a regular basis, and I keep an adrenal-calming supplement handy for periods of time when I am under more stress than usual, which is disrupting my sleep in the pattern described above. Nowadays we live under so much chronic physiologic stress. Traffic, email, constant connectedness with cell phones. Even if we handle stress well, our bodies, especially our adrenals, can use some support.

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