Adrenal Fatigue: The Autoimmune Connection

March 21, 2018

What do your adrenal glands have to do with your immune system? Everything, when it comes to healing your body and living your best life. Your adrenal glands respond to stress and regulate inflammation in the body. Autoimmune conditions are often triggered by stress and depend on healthy adrenal function to prevent a flare up and regulate inflammation. Adrenal fatigue happens when our stress exposure is chronic and our adrenal glands can’t keep up to the demand. My goal as a Naturopathic Doctor is to help you understand this connection, recover your stress response and heal your body.

Adrenal fatigue is a stress related hormonal dysfunction.

When functioning optimally, the adrenal glands help us respond to “stress” or “adapt” to our environment. These tiny glands help us to perform at our best under pressure: they protect us; they help us to feel alert, focused and energized. If we want to thrive we need to support their work and ultimately our survival depends on them.

Our modern environment is over-stimulating and the adrenal glands can’t keep up.

For most of our evolutionary history, the human body evolved to experience short term stresses and long-term periods of rest and recovery for the nervous system and endocrine system. The challenge in the modern world is that we live in a technology driven society where we experience information overload and decision fatigue on a daily basis. The body’s hormonal response is the same regardless if we are fleeing from a predator, experiencing a perceived threat, or just processing too much exciting information. Overstimulation creates a “sympathetic dominant” nervous system and we are not getting nearly enough rest and recovery to meet the needs of our body. Our adrenal glands are working overtime, and when they cannot keep up, the system starts to fall apart.

The adrenal glands are supposed to regulate inflammation.

The adrenal glands produce adrenaline and cortisol in response to stimulation from the brain, specifically the HPA axis. Like a finely tuned volume control dial, when these glands are functioning well they produce just enough stress hormone to protect us and help us perform well, for just the right amount of time. When the gland is fatigued, the connection to the HPA axis is dysregulated; the glands cannot produce a balanced response, the body cannot maintain balance or what science refers to as allostasis and we experience symptoms such as inflammation. If you have an autoimmune condition, you are very familiar with the damaging effects of inflammation on the body and would do anything in your power to better regulate it.

Symptoms of adrenal fatigue and dysregulation:

  • Feeling tired and/or tired and wired
  • An inability to wake up feeling refreshed in the morning
  • Overuse of coffee or stimulants
  • Sugar and/or salt carvings
  • Poor tolerance to stress
  • Frequent infections and a weak immune system
  • Sleep disturbance
  • Pain and inflammation

Repairing the stress response is important for managing autoimmune disease.

Regulating inflammation is essential to your recovery from your autoimmune condition. Autoimmune conditions are characterized by an imbalanced immune system. Autoimmune conditions are diagnosed when signaling in the body changes and the immune system starts to act inappropriately and attack body tissues the same way it would attack a bacterial or viral infection. Recovering your adrenal function can repair the signaling in your body that controls the inflammatory process.

Factors that contribute to autoimmunity include:

  • Genetics
  • Infection
  • Environmental exposures
  • Stress

If we can learn to manage our environmental factors and support our stress response, the body will be better able to fight infection and influence positive gene expression. This understanding is extremely empowering, because it gives us much more influence over our autoimmune condition than we might think. When we understand the stress response, we can protect it, nurture it, love it and repair it.

Does the autoimmune condition trigger the adrenal fatigue or does adrenal fatigue trigger the autoimmune condition?

Autoimmune conditions are often triggered by stress described as adrenal fatigue and at the same time, living with an autoimmune condition can produce a great deal of stress leading to adrenal fatigue. It really does not matter what came first, once you know you have an autoimmune condition nurturing your stress response is essential. Investing your time and energy in lifestyle factors that improve balance for either concern will improve balance for both.

Steps to recovering from Adrenal Fatigue

  1. Start working with a Naturopathic Doctor

If you have adrenal fatigue, chances are you are too stressed to go it alone. Information overload and indecision made worse by adrenal fatigue can make understanding your options very difficult. Your Naturopathic doctor understands the intricate balance between your nervous system and your endocrine system and they have the professional experience to guide you to recovery.

  1. Regulate your sleep routine.

Your adrenal function is dependent on good quality sleep. Adrenal fatigue can cause insomnia and that feeling of being “tired and wired”. Set up healthy boundaries around your bedtime and change your sleep environment to optimize rest. Start by assessing your sleep hygiene. Go to bed at the same time every night. Sleep in a cool, dark room. If you happen to be a mouth breather or have symptoms of sleep apnea, it’s time for a professional assessment.

  1. Choose gentle exercise not excessive exercise.

While movement and exercise are very supportive and necessary for healing, over exercise can cause adrenal fatigue or make your full recovery seem impossible. As your adrenal function improves, you can increase your exercise capacity. Really listening to your body can help, and monitoring your heart rate or heart rate variability can be a great indicator of your capacity to take on more.

  1. Avoid sugar and reduce your carbohydrate intake.

Our goal is to give your body less to adapt to. Changes in your blood sugar caused by eating carbohydrates and the insulin cycle can make it very difficult for your body to self-regulate. Remove the sugar and remove the stress on the system.

  1. Acknowledge your stress and manage your stress.

This is often the most difficult idea to accept. If you have adrenal fatigue, the stresses in your environment have been more than your system can handle. Your environment needs to change and you need to embrace recovery if you want to get better. Fighting through it will just make it worse. Taking pills or supplements alone will not get you where you need to be. Take some time to do some deep self exploration, practice self love and get clear on your priorities. Set up healthy boundaries around your basic needs for human living (nutrition, sleep, exercise, social support) and ensure that your actions are in-line with your health and align with your purpose.

Mindfulness meditation, guided imagery, yoga and counselling are evidence based practices that can help you reduce your stress levels.

  1. Nutrition to fuel your recovery.

Eating a plant based diet that is lower in carbohydrates, void of refined sugar and processed food, and one that emphasizes complete concentrated protein sources, and healthy fats is essential to ensuring that your body is not starving for micronutrients, nor over stimulated by additives. Eating on a regular routine, not skipping meals and avoiding food 2-3 hours before bed, supports your circadian rhythm and will give your body less change to adapt to throughout the day. Your nutrition has the potential to relieve stress or cause stress. Having an assessment of your nutrient timing, nutrient density and the quality of your food is essential to your recovery. When appropriate your Naturopathic Doctor may even recommend fasting as an evidence based practice to help “re-set” your immune system.

If you have an autoimmune condition assessing for food sensitivities and establishing a balance of healthy bacteria or “microbiome” in your digestive tract is key to modulating the immune system and taking the pressure off your stress response.

  1. Supplements including IV therapy.

When your body is stressed it burns through key nutrients much quicker that it normally would. These nutrients are also co-factors for energy, hormone metabolism and neurotransmitter production. When the supply does not keep up to the demand symptoms of fatigue, hormone and mood changes arise. Generally speaking, most people will benefit from B. Vitamins, Magnesium and Vitamin C. However, it is essential that you complete a full assessment with your Naturopathic Doctor so that you do not miss an essential step in recovering your metabolism. Choosing to access nutrients through IV therapy allows the opportunity to saturate your tissues with the key nutrients your cells need to make energy and recover. Once you have worked on the foundation of supporting your sleep routine, addressing your stress and optimizing your nutrition, IV therapy can boost your recovery potential by delivering the nutrients in much higher doses in a shorter period of time than can be achieved orally.

  1. Botanicals

Tonic and nourishing herbs like Withania, Licorice, and Rhodiola have been used for centuries and across cultures to restore vitality. When studied closely their effects help to modulate the stress response, supporting the parasympathetic nervous system and improving adrenal function. Ideally they can give you the performance enhancing energy you need to work on improving your foundational lifestyle changes. Choosing the ideal herb for your health circumstance is the professional responsibility of your Naturopathic Doctor. Especially if you are managing an autoimmune condition or are taking medication.

  1. Clean up the toxic chemicals in your body.

Everyday we are exposed to chemicals like, BPA, plastics, phthalates, heavy metals, pesticides and thousands more. When these chemicals get into our body through our food, water, air and on our skin they stimulate and aggravate our immune system. Our immune system is designed to attack these foreign invaders and the process creates inflammation. The challenge with most of these chemicals is that it can take a very long time for the body to eliminate them. Often our rate of exposure is greater than our rate of elimination and the result is a toxic burden that builds up in the body adding chronic stress to your immune system. Having the knowledge to avoid your exposures and support the body in elimination is essential to your recovery. To get started here are some great evidence based consumer guides to decreasing your toxin exposure. Start working with your Naturopathic Doctor on supporting your metabolism and elimination.

10. Take Your Symptoms Seriously

Suffering from adrenal dysfunction is real suffering. You have the potential to change your path, fighting through it just promotes more fatigue. Supporting your adrenal function is an investment in your long-term quality of life and your overall health. Listening to your body can help you regain your energy and your vitality. Talk to your Naturopathic Doctor, there is help available.


The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.


“Adrenal Fatigue: The 21st Century Stress Syndrome” by James l. Wilson

“Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping” by Robert M. Sapolsky

“The Adrenal Thyroid Revolution” Dr. Aviva Romm MD

Dr. Erin Wiley is a Naturopathic Doctor with a strong focus on preventative and integrative medicine. She is the Owner and Clinic Director of the Integrative Health Institute, an integrative medical clinic located in downtown Toronto. Erin has a strong clinical emphasis on autoimmune conditions, stress related illness, anxiety, depression and hormone balance. As a naturopathic doctor, Erin is passionate about working with people to help them better understand their health and achieve their health goals.



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