How to Manage Adrenal Fatigue Naturally

By Michael A. Smith, MD

Although the human body is pretty good at managing acute stress, chronic psychological stress can produce a variety of dangerous medical consequences — including premature aging.

Chronic stress can increase our risk of suffering from a barrage of anxiety and pressure-related diseases ranging from high blood pressure1 and depression2 to dementia3.

Chronic stress has also been associated with some types of cancer.4,5

To counter the significant adverse health effects produced by chronic stress, conventional medicine regrettably often relies on prescription drugs to mask stress-related symptoms.

However, these drugs fail to address biochemical abnormalities such as imbalanced adrenal hormone levels that contribute to a phenomenon known as adrenal fatigue.

Chronic Stress Fatigues the Adrenal Glands

At the core of chronic stress is deregulation of the hypothalamic-pituitary-adrenal axis or HPA, an interconnected nerve network that governs the production of stress hormones like cortisol and catecholamines like epinephrine.

The subsequent imbalances in stress hormone levels are a critical feature of stress-related illness.

Some alternative doctors will refer to the dysfunctional HPA axis as adrenal fatigue. It seems to be caused by constant stress or poor nutrition which can deplete and weaken the adrenal glands.

There are many symptoms associated with adrenal fatigue, mostly fatigue and weakness. In some patients, thyroid problems overlap or are concomitant with adrenal problems.

If you suffer from chronic stress and adrenal fatigue, you should consider the following:

  • Identify the source of your stress and take steps to find some relief. Consider meditation, prayer or stress-relieving exercises.
  • Consider lifestyle changes such as adopting a healthy diet and increasing exercise. In some studies, exercise works just as well as drugs to help relieve stress.
  • Obtain baseline corticosteroid, DHEA, and pregnenolone hormone levels. Correcting any deficiencies is important for handling stress.
  • Avoid smoking. Nicotine in tobacco initially raises cortisol levels, but chronic use results in low DHEA, testosterone, and progesterone levels.
Now let’s talk about improving your energy level and reducing stress using a couple of nutrients. For most people with adrenal fatigue, this is a great place to start.

Carnitine Helps Improve Energy

How about increased energy? We could all use some of that today. Carnitine is a great choice here. It’s an amino acid that helps to deliver fatty acid into the powerhouses of the cell, called mitochondria, to be burned for energy.

There are three advanced forms of carnitine that you’ll want to look for:

  • Acetyl-L-carnitine crosses the blood-brain barrier to combat oxidative stress and promote energy production in brain cells. This means less brain fog! It also maintains important neurotransmitters like GABA.6
  • Acetyl-L-carnitine Arginate promotes the growth of nerve cell endings that facilitate communication among nerve cells in the brain. This could translate into improved concentration throughout your day.7
  • Propionyl-L-carnitine is a form that offers such benefits as enhanced fatty acid metabolism, antioxidant activity, and increased nitric oxide production for optimal blood flow. It can also reduce muscle fatigue.8

Reduce Stress and Improve Adrenal Function with Herbs

Now what about feeling less stressed out? For this, try ashwagandha. It’s an adaptogenic herb that has been the subject of animal studies and is believed to confer improvements in well-being and a healthy outlook in people.

Ashwagandha, according to Ayurvedic medicine, is able to produce feelings of calm by mimicking the inhibitory neurotransmitter called GABA.9

Next, the Japanese have almost perfected the science of remaining calm and feeling less stressed. They have long known that L-theanine, an amino acid derived from green tea, is a natural relaxant that diminishes stress, without drowsiness, impaired thought or other side effects.

L-theanine produces calming effects in the brain in ways that have been compared to meditation, massage, and aromatherapy. In fact, studies show that L-theanine enhances the brain’s ability to concentrate, learn, and remember.10

Another herb the Japanese use is lemon balm or Melissa officinalis. It’s a perennial herb in the mint family native to the Mediterranean region, and it has been clinically proven to help promote sleep and relaxation.

What’s more, lemon balm produces these calming effects while also enhancing memory and attention.11

The Bottom Line

Whether you have adrenal fatigue or not, reduced stress and increased energy are things that almost anyone can benefit from. So how can we accomplish these goals naturally?

As a first line of defense, exercise and stress management techniques such as relaxation and meditation can really go a long way. If you’re not already working them into your lifestyle, please consider giving them a fair shot.

Beyond that, a number of nutritional supplements can also make a big difference in managing stress and increasing your energy levels to promote optimal health and longevity.

For this reason, we suggest giving carnitine, ashwagandha, L-theanine, and lemon balm a close look!


  1. WMJ. 1998 Dec;97(11):34-8.
  2. Arch Gen Psychiatry. 1999 Mar;56(3):225-32.
  3. Am J Geriatr Psychiatry. 2011 Apr;19(4):327-34.
  4. Nat Med. 2006 Aug;12(8):939-44. Epub 2006 Jul 23.
  5. Psychol Med. 2000 May;30(3):669-78.Saul 2005
  6. J Neurochem. 2010 Aug;114(3):820-31.
  7. Neurochem Res.1995 Jan;20(1):1-9.
  8. J Int Soc Sports Nutr. 2009 Apr 2;6:9.
  9. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):208-13. Epub 2011 Jul 3.
  10. J Herb Pharmacother. 2006;6(2):21-30.
  11. Curr Pharm Des. 2006;12(35):4613-23.


plumbing said...

The adrenal glands, located in the abdomen above the kidneys, regulate stress in the human body. When the body encounters an emergency situation, the adrenal glands release hormones, such as adrenaline, that enable the body to respond accordingly. You may have encountered this reaction, called the "fight or flight" response, if you have encountered danger, fear or shock. Adrenal fatigue is the controversial idea that the adrenal glands can become worn out, creating illness, if continually over stimulated.

Life Extension said...

plumbing – That’s right. With continual amounts of stress, the adrenal glands can eventually “burn out”. Thanks for reading and commenting. : )

Anonymous said...

So...are you saying we should try all 3 forms of carnitine? Plus, with the others, that would be 12 more pills at a minimum, taking twice a day, to add to my already bloated pile of pills I take everyday.
I take the theanine at it! I'm on thyroid med as well. Also DHEA and compounded hormone therapy.

Life Extension said...

Anonymous- You don’t have to try ALL of the forms suggested. For starters, you might just want to try acetyl-L-carnitine - it’s especially helpful for boosting mental energy!

Anonymous said...

thanks for share.

LifeExtension said...

Anonymous - Our pleasure! Thanks for reading. :)

Unknown said...

Very helpful summary. An often overlooked factor relates to some indication that Ashwagandha LOWERS Cortisol production, obviously therefore one of the considerations helpful for beginning stages of Adrenal Fatigue with harmful, reactive excess cortisol production, and if true, harmful for those with Adrenal Insufficiency who have so little capacity for cortisol production.

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