How to Lose Weight When You Have Adrenal Fatigue

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Dr. Khoshaba

January 16, 2023

Struggling with stubborn weight gain or an inability to lose weight? Have you tried fad diet after fad diet, and the scale still won’t budge? I’m here to tell you that it may not be your diet alone that’s preventing you from losing weight... At least not entirely.

We tend to look at weight loss as black and white. Calories in versus calories out. However, we’ve come to understand that it is not that simple. There can be many things contributing to weight gain, including your hormones. 

When was the last time your Doctor checked your bloodwork? Weight gain has so many causes, and it is important to assess the aetiology of your symptoms so you can make the best diet and lifestyle decisions uniquely for you.

Some comprehensive testing that you and your Physician should consider testing include a Complete Blood Count (CBC), Complete Metabolic Panel (CMP), Fasting Insulin, Thyroid Stimulating Hormone (TSH), Cholesterol, hsCRP, Free T4, Free T3, Reverse T3, AM Cortisol, HbA1c, Vitamin D, Vitamin B12, Folate, Vitamin C, Ferritin, Estradiol, Estrone, Progesterone, Testosterone, DHEA-S.

Other specialty testing, including a Comprehensive Stool Analysis, Salivary Cortisol Test, and Food Sensitivity Test may also be indicated. Of many of the causes of stubborn weight gain, adrenal fatigue or adrenal insufficiency may be one of them.

What is adrenal fatigue?

Well, to answer this question, we first need to speak about the adrenals and cortisol. 

What are your adrenal glands?:

How to Lose Weight When You Have Adrenal Fatigue
The endocrine system

Your adrenals glands are a pair of 2 glands located right above each kidney. Your adrenal glands produce several hormones responsible for many of your essential bodily functions. These functions include helping regulate your immune system, stress hormones, metabolism and blood pressure.

The adrenal glands have two parts: the adrenal cortex and the adrenal medulla. The cortex and medulla are each responsible for producing hormones. There are specific conditions associated with too little or too much production of adrenal hormones.

The adrenal cortex makes up most of your adrenal gland and is the outermost part of your adrenals. Your adrenal cortex is made up of 3 zones that each produces different hormones; these zones include the zona glomerulosa, zona fasciculata and zona reticularis.

The zona glomerulosa secretes aldosterone, the zona fasciculata secretes cortisol and the zona reticularis secretes both androgens (DHEA and androstenedione, both made from cholesterol)  and a small amount of glucocorticoids. Aldosterone is a steroid, released by the zona glomerulosa that is responsible for regulating the salt and water in your body, having an effect on your blood pressure. DHEA is a hormone that is a precursor to your other hormones, like testosterone and estrogen. 

The adrenal medulla, the innermost part of the adrenal gland, secretes primarily epinephrine and norepinephrine. Epinephrine and norepinephrine are your stress hormones and neurotransmitters  that are often released when you are in “fight or flight.”

These chemicals cause your blood pressure and heart rate to increase and your blood sugar to go up. Epinephrine has a greater effect on your heart, and norepinephrine affects your blood vessels, causing them to constrict which is why your blood pressure goes up. 

What is cortisol?

Cortisol is a glucocorticoid hormone that is produced and secreted by your adrenal glands. Cortisol is also known as your stress hormone. Your cortisol plays a large role in regulating your blood sugar, blood pressure, circadian rhythm, energy, metabolism and inflammation.

In normal adrenal function, cortisol should be highest in the morning and reduce as the day progresses. Cortisol is usually tested first thing in the morning (before 9 am); however, a more salivary test may be ordered that assesses your cortisol throughout the day.

What are ideal cortisol levels?

Typically, cortisol is tested first thing in the morning. The reason being is that your cortisol should be highest in the morning and drop as the day goes on. Morning cortisol levels should be between 6.2−19.4 μg/dL. If your cortisol is below that or at the bottom range of “normal,” it indicates you have a low cortisol awakening response. There can be many causes of this, some of which include Addison’s Disease, physiological burnout, chronic fatigue, poor sleep, or chronic pain. All of these can contribute to adrenal fatigue.

Back to adrenal fatigue... What is it exactly?

Adrenal fatigue is a condition whereby your adrenal glands have endured a lot of stress and have been overworked, causing them to produce less cortisol. When this happens, you experience symptoms associated with low or suboptimal cortisol. Some signs associated with adrenal fatigue include:

  • Fatigue
  • Insomnia
  • Trouble falling asleep
  • Weight gain
  • Brain fog 

Your physician should assess you for a more serious condition, like Addison’s Disease, as the treatment will vary. Some signs of Addison’s Disease include:

  • Salt cravings
  • Weight loss
  • Muscle weakness
  • Loss of appetite
  • Fatigue
  • Skin discoloration or hyperpigmentation 
  • Lightheadedness
  • Dizziness 
How to lose weight with Adrenal fatigue

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Dr. Linda Khoshaba is the Leading Integrative Health and Hormone Doctor in Scottsdale, Arizona. She has extensive experience working in the field as a Hormone Specialist and Natural Endocrinologist.

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