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Today, we will talk about adrenal fatigue, what the adrenal glands are, what cortisol is, and what to do about it.

The adrenal glands are paired organs located above the kidneys. As the name suggests, they are positioned at the top of the kidneys. These are endocrine glands that produce hormones such as aldosterone, adrenaline, and sex hormones—progesterone, estrogen, and testosterone.

Cortisol is a hormone that regulates the body's response to stress. The concentration of cortisol is influenced by the work of the pituitary gland and the adrenal glands, as well as physical and emotional overload.

From a physiological point of view, adrenaline is a hormone released into the blood in response to stress. It is produced in the adrenal medulla, but the adrenaline receptors are found in all organs and tissues of the body. This means that the stress response, including adrenaline and cortisol, will be manifested in every cell of the body, causing it to react accordingly.
There are two types of stress: positive (eustress) and negative (distress). Eustress does not require recovery; it subsides on its own after the stressful situation ends, for example, after a competition, an exam, or an important event. For instance, when we run late for a flight and immediately calm down once we board the plane.

Negative stress can be physiological and psychological, and it affects the release of cortisol and adrenaline in the body.

Physiological stress is caused by external factors such as strong odors, loud noises, bright lights, extreme temperatures, high physical load, hypoxia, hypoglycemia, and pain—these physical discomforts increase cortisol levels in the body.
Psychological stress can be triggered by situations such as an accident, a fight, an argument, high responsibility, a divorce, the loss of a loved one, or informational stress (sudden events, novelty, lack or excess of information). In today's world, where we constantly scroll through news feeds, informational stress also plays a role.

Stress, whether physical or psychological, can become chronic. Normally, adaptation to stress takes no more than a month. If this does not happen, chronic stress develops, associated with prolonged exposure to unfavorable conditions. Chronic stress can be recognized by psychological symptoms such as unexplained anxiety, panic attacks, and a constant sense of unease. Cortisol levels remain elevated in the blood, and additional physical symptoms may appear.

Chronic stress can also manifest in increased sensitivity to light or sounds. For example, regular light bulbs may start to irritate, or loud sounds may become bothersome. People may experience increased physical activity—they find it hard to stay still, often walking around or fidgeting. A characteristic symptom is getting stuck in traumatic situations—the person cannot stop thinking about what happened and cannot distract themselves with other things.
Furthermore, chronic stress affects the body’s ability to adapt to exercise. A symptom that the adrenal glands are not coping with the load is poor exercise tolerance and fatigue, which can last for several days. For example, if someone trains in the morning, feels fine, but then comes home and can do nothing but lie down and recover throughout the day or even for several days, it signals that the load was too much for their body. In such a case, the training load should be reassessed, and the person’s condition should be analyzed.

If these symptoms arise, it is best to undergo tests for stress levels or consult a specialist. Most often, it is more effective to work with such a person through a specialist. It is also important to always ask clients about how they are feeling and how they typically cope with stress, and whether they are currently experiencing stress. This will help select the right training program without harming their health.

There are three main reactions to stress: "fight," "flight," or "freeze." This is an ancient survival mechanism that helped humanity cope with threats. It was activated to survive, for example, to run away from a predator or hide from danger.

Fight is the fight response. Flight is the escape response. Freeze is the freeze response, where the person freezes with fear.

These reactions trigger the release of cortisol, which increases heart rate, raises blood pressure, and helps the body adapt to the stressful situation. However, if the stress cycle does not properly end, it can lead to serious consequences for the body, such as heart problems, endocrine disorders, depression, and even the development of malignant tumors in cases of prolonged stress.

How to properly end the stress cycle, stay productive, and not harm yourself in such situations—this is what we will discuss below

How to end a stressful situation depends on your personal reactions and coping strategies. Let's consider the three main stress reactions:

1. "Fight" reaction — This is when a person becomes aggressive, reacts quickly to a stressful situation, experiences a strong adrenaline rush, and has difficulty controlling emotions. In such cases, it is important to find a way to release emotions. It might be helpful to isolate yourself in a room or go outdoors to shout or punch a pillow. A strength training session, where there is a moment of intense tension and relaxation, can also be effective. It is also important to learn how to express aggression in a healthy way, experience the stress moment, and properly express your emotions.
2. "Flight" reaction — This is when a person tries to avoid stress or the task at hand. In these situations, you can go for a short run or do interval training (e.g., run 100 meters several times). It's important to force yourself to return to your tasks afterward and work on procrastination. You can make a to-do list, understand why you don’t feel like doing something, and address it. The reasons for avoidance usually boil down to three: not knowing how and what to do, or fear of the task. You can work through this with a psychologist or by yourself, writing down your fears and deciding how not to avoid stressful situations.
3. "Freeze" reaction — This is when a person freezes, not knowing what to do in a stressful situation and taking no action. To return to reality, you can use massage techniques, self-massage, meditation, attention-focusing methods, or slow-paced activities like yoga or Pilates. These will help improve the connection with your body and bring you back to an active state.

By combining these methods depending on your type of reaction, you will be able to handle stress more quickly and effectively, preventing it from becoming chronic, which can lead to adrenal fatigue.

Adrenal fatigue is often masked as various forms of emotional and professional burnout, neuroses, nervous breakdowns, or even postpartum depression. The causes can be related to pituitary damage during difficult childbirth or chronic stress. Allergies, such as hay fever or environmental allergies, can also be connected to adrenal fatigue.

Other symptoms include frequent colds without a fever (e.g., chronic runny nose or cough), dizziness, low blood pressure, morning weakness, headaches (due to blood vessel spasms), skin problems (acne, eczema, psoriasis), and chronic fatigue syndrome. All of these symptoms may indicate adrenal fatigue, and in such cases, it is important to undergo an examination.

Laboratory tests to assess adrenal fatigue include cortisol and dehydroepiandrosterone (DHEA) levels, as well as sex hormones. DHEA is a precursor to sex hormones, and its level decreases with age. In the early stages of adrenal fatigue, cortisol and DHEA levels will be elevated as the adrenal glands are actively producing these hormones. In these cases, it is recommended to take full rest, a vacation of at least 21 days, and use adaptogens and vitamins. In more severe cases, cortisol and DHEA levels decrease, and serious therapy prescribed by a nutritionist or integrative doctor may be required.

Regarding nutrition, a proper diet is crucial in cases of adrenal fatigue. Intermittent fasting, carbohydrate restriction, keto diets, and calorie reduction are prohibited. These can worsen the problem and harm your health.

If a person comes to you with the goal of weight loss, it is important to test them for signs of adrenal fatigue and correctly tailor their diet. If you see that the stage of fatigue is not too advanced, at least you should avoid prescribing extreme dietary methods, such as intermittent fasting, low-carb, or ketogenic diets. Instead, you can recommend a more balanced diet, such as the Mediterranean diet.

What happens if a person sharply restricts calories while under stress? The body perceives this as a signal of even harder times ahead, which leads to a slowdown in metabolism. When the person returns to their normal eating habits, the body starts to actively store energy in the form of fat. This can also trigger panic attacks, nightmares, and develop depression, which are signs of worsening adrenal fatigue.

With adrenal fatigue, it is important to include complex carbohydrates in small amounts with each meal. It is acceptable to eat 3-5 times a day, with main meals and snacks. Dinner should be closer to bedtime, about 2 hours before sleep, and should include a portion of carbohydrates. Breakfast should be as close as possible to the time of waking. If the person is not used to having breakfast, it can be prepared the night before.

Additionally, it is necessary to avoid coffee, alcohol, and caffeinated beverages, such as black and green tea, as caffeine can displace aldosterone from the adrenal glands, worsening the condition. The withdrawal from caffeine should last from one month to a year, depending on the stage of adrenal fatigue.

Now let’s talk about adaptogens — natural substances that help the body adapt to stress, protect against the destructive effects of cortisol, speed up metabolism, boost immunity, and help manage psycho-emotional stress. Adaptogens are useful during increased physical and mental exertion, as well as in stressful situations.

Examples of adaptogens include Rhodiola Rosea, Motherwort, and Peony extract. These can be recommended for the early stages of adrenal fatigue. Adaptogens should be taken immediately upon waking, in drops (10-20 drops), for 6 weeks or longer, depending on the stress level. These can come in tincture or tablet form.

If the problems become serious (panic attacks, nighttime awakenings, depression), the person should be referred to a specialist, such as a nutritionist or doctor, for further examination and personalized therapy, including adaptogens, vitamins, and other medications based on the patient's condition.

Important aspects of recovery for people with adrenal fatigue: daily routine and sleep hygiene.
For individuals with adrenal fatigue, maintaining a proper sleep routine is especially important. It is essential to stick to a strict schedule, going to bed on time — ideally before 10:00-11:00 PM. This is crucial because many people often stay up late, until 1:00 or 2:00 AM. Such late bedtimes significantly worsen health. It is also necessary to wake up at the same time every day, regardless of whether it's a weekend or a workday. This helps avoid additional stress for the body.

Additionally, prolonged sleep on weekends should also be avoided, as it causes extra stress. It's better, for example, to schedule workouts for the morning on a weekend day to maintain a stable routine.

Why is going to bed early important? Melatonin, the hormone that is produced from about 10:00 PM to 2:00 AM, plays a crucial role: it has anti-inflammatory properties and regulates other hormones, influencing how a person feels the next day. If a person goes to bed late, it disrupts melatonin production, which can lead to issues such as cravings for more sugary foods, digestive problems, and ultimately weight gain.

Sleep hygiene also plays a vital role. Sleep should take place in a cool, well-ventilated, and dark room. Ideally, blackout curtains should be used in the bedroom. All light sources, including nightlights and LED indicators, should be removed, as light, even through closed eyelids, reduces melatonin production.

One should also avoid working with gadgets or keeping phones near the head during sleep. Electromagnetic radiation from such devices can disrupt sleep quality. Ideally, Wi-Fi should be turned off at night.

Inadequate sleep in unsuitable conditions is also a stressor for the body, which further affects adrenal function. Working during the night, especially for women, is particularly detrimental and may contribute to the development of diseases, including cancer, in the future.

How to Train a Client Under Stress: Recommendations
If you know that your client is experiencing stress or their body is in a state of adrenal fatigue, it is important to be mindful of their condition during the workout. Stress leads to the loss of electrolytes, especially sodium and magnesium. In this case, you can suggest that the client dissolve a few crystals of coarse salt in the morning and take magnesium at night — a dosage of 200-400 mg would be adequate.

If, during the workout, the client feels dizziness, blurred vision, or exhibits symptoms of hypoglycemia (weakness, headache), you can offer them a few salt crystals or a small amount of sugar or honey (up to a teaspoon) to improve their condition. At the same time, the intensity of the workout should be reduced.

Additional Recommendations:

• Reduce the load during stress, and incorporate breathing exercises or meditation.
• Use approaches from yoga to support adrenal function.
• Recommend B vitamins (B1, B2, B5, B6) and vitamin C to support the body. The daily dosage of these vitamins will help improve well-being in stressful situations.
• If the effects of stress are severe, such as panic attacks or depression, direct the person to a nutritionist or doctor for further treatment.
• Do not take responsibility for prescribing complex therapeutic procedures without consulting a doctor.

Conclusion
To restore health and harmony with the body, it is crucial to consider multiple factors, including daily routine, sleep schedule, appropriate exercise, and proper nutrition. These measures will help effectively maintain health, improve well-being, and prevent negative consequences of stress and adrenal fatigue.