Susan Merenstein, Pharmacist/Owner

(412) 586-4678

The Adrenals - Your Survival Glands

Your adrenal glands sit on top of your kidneys, hence the word “Ad” (on top of) and Renal (kidneys). They regulate many critical hormonal jobs as well as make about 50 hormones in your body, but one of their primary jobs is to control the release of your main stress hormone, cortisol. Cortisol is essential for survival.

Our bodies are built for stressful events. When our ancestors were chased by predators, the sympathetic nervous system responded by switching the body into fight-or-flight mode. During this stress response, the adrenal glands release adrenaline and then cortisol, which increase blood pressure and blood sugar for faster response and better survival. When the predators were gone, cortisol decreased, and so did blood pressure and blood sugar levels. Normal balance was restored. However, ongoing stress (that feels like an animal chasing you) doesn’t turn it back off.

What is Adrenal Fatigue or HPA axis Dysfunction?

Conventional medicine does not recognize the term “Adrenal Fatigue”

In a healthy individual, cortisol is higher in the morning to help with waking, and slowly lowers throughout the day. Melatonin, your “sleepy time” hormone, is inversely proportional to cortisol, so when cortisol is high, melatonin is low and vice versa. Adrenal fatigue happens when there is an imbalance in this cortisol rhythm. Cortisol is either low when it should be high, high when it should be low, or always low or always high.

But the problem isn’t isolated in your adrenals. Your brain tells your adrenal glands what to do through a complex web of communications called the hypothalamic-pituitary-adrenal axis (HPA axis), or simply the brain-adrenal axis. Your hypothalamus releases corticotropin-releasing hormone (CRH), which tells the pituitary gland to release the adrenocorticotropic hormone (ACTH). ACTH then tells your adrenal cortex to release cortisol.

Adrenal fatigue is really a dysfunction of your brain’s communication with your adrenals – not the adrenal glands themselves.


Chronic stressors include:


  • Slow to start in the morning
  • Cravings for salty or sugary foods
  • Low libido
  • Fatigue in the afternoon
  • A “second wind” in the evening
  • Inability to stay asleep
  • Dizziness when standing up quickly
  • Afternoon headaches
  • Blood sugar issues
  • Chronic inflammation
  • Weak nails and brittle hair
  • Moodiness
  • Difficulty losing weight.

1. Diagnostic labs

Because adrenal fatigue symptoms are so non-specific and could be indicative of other diseases such as depression, sleep apnea, fibromyalgia, and certain autoimmune diseases, it can be hard to make a medical diagnosis. Seeing a medical professional or endocrinologist to establish a baseline of what’s going on in the body is the first step to overcoming adrenal fatigue. In addition to conventional blood labs, I recommend:

  • Adrenal fatigue labs: This saliva test involves spitting into several vials throughout the day and helps to determine the HPA axis dysfunction.

  • Microbiome labs: The microbiome refers to the community of trillions of bacteria and fungi in your gut. Because gut health is the foundation of total health, especially brain and hormonal health, it is important to discover what is going on and deal with any underlying gut problems such as leaky gut syndrome, candida overgrowth, and small intestinal bacterial overgrowth in order to recover from adrenal fatigue. Megaspore Biotic

  • Methylation labs: Methylation is a collection of biochemical actions in the body that happen 1 billion times every second. Healthy methylation helps to maintain a healthy brain, gut, hormones, and detox pathways, and also protects your DNA. However, some of us have genetic mutations that impair the methylation process, one of which is the MTHFR gene mutation, making people less able to absorb certain essential vitamins. Vitamin B12

2. Curb chronic stress

Another key element of adrenal fatigue treatment is managing chronic stress. Pinpoint your key areas of stress and unburden, watch for food intolerances, detoxify your environment, and lessen your schedule. Allow for periods of rest and relaxation, so you can break the chronic stress cycle.

3. Calm inflammation

Curcumin, a compound in the turmeric root, has potent antioxidant properties, as well as a neuroprotective quality. Bonus: It’s a mood-enhancer, too. In a randomized controlled trial, turmeric appeared to act as an effective option for depression, (1) which can occur concurrently with adrenal fatigue. Acetyl Glutathione quells inflammation and provides mitochondrial energy.

4. Eat nutrient-dense proteins


Oysters are packed with zinc, and having a balanced trace mineral ratio between copper and zinc can help with healthy neurotransmitter function and adaptogen to stress. Increased copper and decreased zinc have been shown to contribute to brain stress and anxiety.

Organic turkey

The (post turkey coma) is partially related to the calming amino acid tryptophan in the turkey. Tryptophan is a precursor to the neurotransmitter serotonin, which helps you feel calm and better able to deal with anxiety.

Grass-fed organ meats

Organ meats like liver are some of the best sources of nutrients needed to beat adrenal fatigue, like zinc and vitamin D. They contain plentiful amounts of choline and other B vitamins needed for methylation.

5. Green Superfoods

Leafy greens

Plant foods like Swiss chard, kale, and spinach are rich in magnesium, the original “miracle mineral”, which helps to regulate and optimize communication in the brain-adrenal axis.


This sulfur-rich vegetable also contains the beneficial B vitamin folate. Low levels of folate are linked to neurotransmitter impairment, which can lead to brain-hormonal problems.

6. Healthy Fats


Avocados contain beneficial B vitamins and monounsaturated fats that boost neurotransmitter production and brain health. This fatty superfruit also contains potassium, which naturally helps to lower blood pressure.

Full-fat kefir

Bacterial imbalances in your gut can contribute to brain problems because the gut and brain “talk” to each other through the vagus nerve. Kefir is rich in beneficial bacteria for your microbiome and also has fat-soluble vitamins A, D, and K2, which are important for brain health, so it helps out from both ends of this critical connection.

Coconut oil

Coconut oil is very versatile – you can cook with it, put it in smoothies, or just eat it off a spoon. It offers good fats like medium-chain triglycerides (MCTs) that can help with brain function.

Wild-caught fish

Omega-rich foods like Alaskan salmon, sardines, krill, and herring can help decrease inflammation, which is crucial for brain and hormonal health.

7. Breathe and Be Mindful!

You breathe all day long, but doing it consciously and with focused awareness is a powerful practice for reducing the stress response. Take time throughout the day to become aware of your breath and you’ll diffuse stress. Mindfulness tools like focused breathing can help you stay calm and soothe your brain-adrenal axis.

8. Herbal teas

Chamomile tea

This soothing, mild herbal tea isn’t actually from the tea plant. It’s made from an herb, Matricaria recutita, that has been shown to help decrease anxiety, depression, and stress symptoms in just a few weeks.

Rooibos tea

Another non-tea “tea,” this one comes from the African red bush, typically known as Rooibos, and can have a balancing effect on cortisol.

9. Natural Medicines

It’s important to discuss natural medicine therapy with a qualified practitioner who can make personalized recommendations based on your needs. However, here are some general natural medicines that can help lessen the stress response:

  • Adaptogenic herbs: Ashwagandha, Rhodiola Rosea, Holy Basil, and Eleuthero Ginseng can have a regulating effect on cortisol rhythm. (cortisol calm, Ashwagandha, Rhodiola)

  • Magnesium: Works to help support the adrenal glands, relaxes stressed muscles and nerves, and promotes quality sleep. It can also help keep you regular. (Magnesium Bisglycinate Chelate)

  • Methylation support: Taking activated forms of B12 and folate are effective ways to support healthy methylation pathways, which help balance the melatonin-cortisol rhythm. (Active B12/FA meltaway)

  • GABA support: GABA is your calming, inhibitory neurotransmitter and herbs like passion flower and amino acids such as theanine (L-Theanine), glycine, and taurine can help calm you down by acting on the gabaminergic pathways in your brain. (Gaba SAT)

10. Sleep!

In order to allow your brain and adrenals to recuperate overnight, you need to get enough sleep. Promote quality sleep by turning off the TV and smartphone at least 2 hours before bed and read a book instead. Most professionals recommend at least 7 hours per night for adults.

11. Get Outside!

There is something coded in our DNA that gives each of us an affinity with the sun and fresh air so that we seek out these health-boosting influences. Practice “earthing”, or walking barefoot outside to de-stress. We are one with the earth and all its elements. Did you know that trees “speak” to us chemically?

12. Vitamin D

Spending more time outside in the sun also helps boost levels of vitamin D, because your body manufactures this important vitamin/hormone when it senses the sun on your skin. Vitamin D is responsible for regulating over 200 genetic pathways, so make sure your levels are high enough. The optimal range is 60 to 80 ng/ml. Ask us about a simple blood test (Vitamin D test) to help you keep track. Supplement with Vitamin D3 only (Vitamin D3 5000) and multiply your weight by 45-50iu to get a more accurate serving.

13. Just say “no”!

Managing stress means creating space in your life to refuel, spend time with the people you love, and doing what you need to do for you and you alone. It’s not selfish, it’s self-love!

14. Balance your hormones!

Depending on your individual brain-adrenal dysfunction, you may need to work with a qualified practitioner to assess your condition and carefully replace a small portion of the levels of the missing adrenal hormones for a period of time. That’s where functional medicine comes in. Specific amounts of DHEA and the precursor to cortisol, called pregnenolone, can stimulate your body to begin producing it naturally, but you need professional guidance to determine how much and how often. I have over 20 years of experience out of my 40 plus years of Pharmacy Practice helping women and men balance their hormones. (Combo Saliva Blood Spot test kit)

We can heal our bodies to create optimal health and function!