Insomnia and Adrenal Exhaustion


"Adrenal fatigue" is a state of depletion of the hormonal reserves in the adrenal glands (hypoadrenia or adrenal hypofunction), the glands that are responsible for the production of adrenaline, cortisol, DHEA, all of which support the body's efforts and capacity to deal with the many demands of life.


In adrenal exhaustion, the glands are unable to secrete adequate amounts of adrenocortical hormones and our ability to deal with life dramatically decreases.


Individuals suffering from it are usually "burnt-out", extremely fatigued, they wake up tired instead of waking up refreshed by sleep, and unlike the healthy pattern of energy production, they feel very tired in the morning and until the afternoon, and tend to feel more energized towards the hours of the evening.



There are 3 stages in the progression from feeling tired to being officially burnt-out.  

In which one are you now?


STAGE I: "ACUTE OR ALARM STAGE" - normal "fight or flight" response to short term stress. Levels of stress hormones rise but then go back to normal. In this stage the body "reacts" to the stressors.


Some consequences may be:

  • Decreased body weight
  • Gastric ulceration
  • Immune activity is suppressed


STAGE II"RESISTANCE / ADAPTATION STAGE" - state of adrenal stimulation. Cortisol rises. DHEA initially stays stable but then starts to fall. In this stage the body "resists" the stressors as best as it possibly can and the individual becomes "used" to the stressors as they occur over a prolonged period of time


Some visible consequences can be:

  • Increase in body weight
  • Depression
  • Anorexia
  • Increased recurrence of fungal infections
  • Panic attacks
  • Gastritis 
  • Hyperlipidaemia
  • Insulin resistance
  • Type II diabetes
  • Hirsutism & alopecia in women
  • Metabolic syndrome
  • Atherosclerosis


STAGE III: "EXHAUSTION STAGE" - this is the later phase of the compensation response when both DHEA and cortisol levels fall out of normal range, with consequent failure of the "stress response" leading to established adrenal fatigue or adrenal exhaustion


Some consequences may be:

  • Decreased resistance to stress in general
  • premature aging
  • Chronic Fatigue Syndrome
  • Fibromyalgia
  • Hypotension
  • Functional Hypoglycaemia
  • Exhaustion of the adrenal glands





Many chronic or long-lived stressful situations can lead to adrenal fatigue. Some examples are:

  • A painful divorce
  • A long and exhausting daily commute to work after stressul days at work
  • A hostile environment at work (humiliation, negativity, unfair conditions, unrealistic expectations)
  • Noisy neighbours disturbing your sleep or your peace
  • A chronic illness that doesn't improve (especially a respiratory illness)
  • An infection
  • Any physical pain that doesn't go away;  
  • Job loss
  • A break-up with a loved one particularly difficult to overcome
  • The death of a loved  one (especially a child)
  • Malnutrition
  • Being severely overweight
  • Excessive exercise like frequent training and comptetion for marathons and triathlons with little or poor recovery programs 
  • Night shifts
  • Raising small or demanding children without help
  • Insomnia (not being able to sleep well or enough)
  • Dehydration
  • Allergies & food intolerances that are untreated
  • Toxic chemicals
  • Physical injury
  • Surgery
  • Emotional traumas
  • Financial problems, bankruptcy, debt
  • Repetitive arguing
  • Ridicule or humiliation
  • etc.


The effects of stress are cumulative!





  • Find it difficult to get up in the morning;
  • Wake up in the morning feeling still tired. Fatigue is not relieved by sleep.
  • Have strong cravings for salty foods like crisps, pop-corn, added salt to your meals, etc.;
  • Feel lethargic or lacking energy to cope with the usual tasks of the day;
  • Feel like you need to work harder and apply an increased effort to do every task of the day (cooking, getting showered and dressed, making a phone call, etc.);
  • Have lost your libido or your sexual drive has diminished;
  • Have lost your usual ability to handle stress (you're less tolerant, less patient, snappy, moody, are easily tearful with the least event, feel anxious more than ever; dealing with your kids is a huge effort etc.);
  • Need increased time to recover from a cold; a flu; or any illness or injury;
  • Feel depressed;
  • Feel a blackout or a severe drop in energy levels if you skip a meal (hypoglycaemia) so use sodas, coffee, and other stimulants to help you keep up with the demands of the days;
  • Have difficulty focusing; forget things easily;
  • Tend to experience a low of energy between 3pm and 4pm (time for comforting snacks!);
  • Somehow feel energised after 6pm and dinner.



"We need to move beyond asking what drug will treat the symptoms, and instead ask what mechanism creates altered neurochemical or neurobiological function or systemic physiological change".     - Dr. Jeffrey Bland  PhD, FACN, FACB, CNS




To conventional medicine, "hypoadrenia" means Addison's Disease - not "adrenal exhaustion" .  Addison's Disease  (also called hypoadrenalism or adrenal insufficiency) is "a rare, potentially fatal condition where the adrenal glands cease to function". People with Addison’s disease require life-long, daily treatment with replacement steroid hormones. 


Consequantly, physicians only run tests to detect hypoadrenia as Addison's Disease, which can put in a difficult place a very run down person not suffering from Addison's Disease, as the lab results will come negative.  This means that although there is clearly a dysfunction in the hypothalamic- pituitary- adrenal axis which regulates the stress response, the lab tests won't pinpoint markers of any full blown disease and you will be just advised to go back home and rest or will be given a prescription for an anti-depressant.


It is in this case that a holistic health plan to support such fatigue becomes crucial for the patient.

My functional medicine plan for insomnia & adrenal exhaustion



The first step required in order to understand the causes & triggers of your fatigue will be to investigate adrenal function with functional diagnostic evaluations. 


The Adrenal Stress Profile is a  test which, unlike blood hormone testing assesses the biologically active compounds that are active at the cellular level (and not the inactive ones in other tissues, like blood). This test enables me as a clinician to have a clinically relevant picture of the function of your stress hormones over the course of an entire day (instead of having a lab test that shows hormonal activity during one single isolated short moment of your day). 


This functional diagnostic test can detect imbalances in the daily circadian (day/night) secretions of the stress hormones cortisol and DHEA. Imbalances in these hormones can signal an inadequate response that can negatively affect energy levels throughout the day and night, emotions, and many other health issues related to stress & fatigue like anxiety, chronic inflammatory conditions, allergies, chronic fatigue syndrome, insomnia, depression, migraines, headaches, recurrent infections, menstrual complaints, and infertility.


Depending on your individual case, additional functional diagnostic tests may be required.


Your health plan to achieve optimum energy levels and support your HPA axis will inclue the following:

  1. Removal of existing environmental allergens, bacteria or other pathogens, toxins, irritants, etc. that can hamper  healthy energy production in the body;
  2. A diet designed for your specific nutritional & therapeutic requirements - utilising key healing foods known in ancient traditional medicines to support adrenal output and restore adrenal health.
  3. The use of target nutrients that support the steroid hormone pathway; adaptogenic herbs; glandular extracts; etc.
  4. Salt water therapy -to support production and healthy function of the hormone aldosterone.
  5. Yoga & meditation for stress & fatigue - recommendations on what type of yoga asanas, meditation, and pranayama to practice in order to manage & downregulate stress and fatigue.
  6. Other advice on stress management.

The power of nutrients!

In functional medicine we prescribe a delicious, nutrient-dense, fat-rich diet, to support healthy adrenal function and restore rejuvenating sleep again.



Insomnia is a multifactorial phenomenon and you may or not be aware of the causes and triggers.


Some factors affecting people’s sleep are:


A) Physical (metabolic, hormonal, physiological, injury, pain, etc.);

B) Emotional trauma or emotional stress (sadness, anger, bitterness, difficulty forgiving others, hopelessness, etc.);

C) Psychological (rumination, doubts, mental repetition of the same ideas or obsessions, fears, unresolved issues, etc.).

D) Environmental (disturbing noise, bad mattress, room temperature, geopathic factors, etc.).


We can discuss all these possible causes during our consultations and I will refer you on to other relevant therapies to complement your health plan with me, like: art therapy, yoga, meditation, massage, hypnotherapy, bioenergy, etc.


Please note that I may require one or more functional diagnostic tests to investigate underlying issues with adrenal function, methylation, neurotransmitter function, gut health, inflammation, toxicity, nutrient status, etc.

If you're currently experiencing sleep issues and/or are feeling overwhelmed with fatigue, please get in touch with me asap:

+44 07 87 20 22009


+44 078720 22 009

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-Graefes Arch Clin Exp Ophthalmol. 2015 Sep 4. Epub 2015 Sep 4. PMID: 26340868

"Animal studies show that holy basil helps the body maintain homeostasis of the stress hormone cortisol.1 It rebalances mood-associated neurotransmitters in the brain—specifically ones that can produce feelings of hopelessness, which is a key component of stress-induced depression."2

1- Phytother Res. 2016;30(5):805-14

2-Indian J Med Res. 2012;135(4):548-54




"EGCG (from green tea extract) regulates genes involved in fat oxidation and storage, as well as genes involved in insulin signaling and glucose metabolism."

-Planta Med. 2004 Nov;70(11)


"Effect of unsaponifiable extracts of avocado and soybean (Piasclédine) on the collagenolytic action of cultures of human rheumatoid synoviocytes and rabbit articular chondrocytes treated with interleukin-1."

- Rev Rhum Mal Osteoartic. 1991 Apr;58(4):241-5. PMID: 1647544

"This meta-analysis showed a significant effect of supplementation with Spirulina in reducing plasma concentrations of total cholesterol, LDL-C, triglycerides and elevating those of HDL-C."

- Clin Nutr. 2015 Sep 25. Epub 2015 Sep 25. PMID: 26433766

"Supplementation with olive leaf polyphenols for 12 weeks significantly improved insulin sensitivity and pancreaticβ-cell secretory capacity in overweight middle-aged men at risk of developing the metabolic syndrome."

- Liggins Institute, University of Auckland, Auckland, New Zealand. Dec 31, 2012


"A coconut extra virgin oil-rich diet increases HDL cholesterol and decreases waist circumference and body mass in coronary artery disease patients."

- Nutr Hosp. 2015 ;32(5):2144-52. Epub 2015 Nov 1. PMID: 26545671

"Lycopene, the predominant carotenoid in tomatoes and tomato-based foods, is reported to protect against various cancers, especially prostate cancer. 

Cell growth was inhibited 20% at 0.2 microM lycopene and 40% at 50 microM lycopene after a 24-hr incubation. In the Comet assay, lycopene-treated cells showed less DNA damage than did placebo-treated cells. The inhibition of Hep3B cell growth in this study demonstrates the antitumor properties of lycopene."

- Biofactors. 2005 ;23(3):129-39. PMID: 16410635

"Accumulating evidence indicates that abdominal adiposity is positively related to cardiovascular disease (CVD) risk and some other diseases independently of overall adiposity. However, the association of premature death resulting from these diseases with abdominal adiposity has not been widely studied, and findings are inconsistent. In a prospective cohort study of 44,636 women in the Nurses' Health Study, associations of abdominal adiposity with all-cause and cause-specific mortality were examined. During 16 years of follow-up, 3507 deaths were identified, including 751 cardiovascular deaths and 1748 cancer deaths. After adjustment for body mass index and potential confounders, the relative risks across the lowest to the highest waist circumference quintiles were 1.00, 1.11, 1.17, 1.31, and 1.79 (95% confidence interval [CI], 1.47 to 1.98) for all-cause mortality; 1.00, 1.04, 1.04, 1.28, and 1.99 (95% CI, 1.44 to 2.73) for CVD mortality; and 1.00, 1.18, 1.20, 1.34, and 1.63 (95% CI, 1.32 to 2.01) for cancer mortality (all P<0.001 for trend). Among normal-weight women (body mass index, 18.5 to<25 kg/m(2)), abdominal obesity was significantly associated with elevated CVD mortality: Relative risk associated with waist circumference>or = 88 cm was 3.02 (95% CI, 1.31 to 6.99) and for waist-to-hip ratio>0.88 was 3.45 (95% CI, 2.02 to 6.92). After adjustment for waist circumference, hip circumference was significantly and inversely associated with CVD mortality."

-Circulation. 2008 Apr 1;117(13):1658-67. doi: 10.1161/CIRCULATIONAHA.107.739714. Epub 2008 Mar 24.

"Major changes in self-reported eating behaviors included eating only when experiencing true physiological hunger and stopping when sensing a feeling of fullness. Self-efficacy for these behaviors was reported to be enhanced by observing weight loss for themselves or others. Support from other group members, the simplicity of the program, and spiritual benefits through prayer and scripture reading were also reported to enhance confidence. Women indicated that they relied on an internal locus of control based on a sense of self-discipline.


Traditional means to enhance self-efficacy were important for all women; however, for some women, spirituality was also an important aspect of adhering to program principles."

- J Nutr Educ Behav. 2004 Jan-Feb;36(1):13-5.

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