The Definitive Guide to Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Modern World

One of my goals with this weekly column is to make significant human health issues easy to understand and discuss. I was pleased that last week’s piece, the Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes, garnered some rave reviews. The Case Against Cardio piqued some great conversation and interesting criticisms (one soul out there in the webosphere took issue with the fact that I positioned Cardio exclusively from my personal perspective as a runner rather than authoring a more scholarly article. Well wasn’t that spot on. It’s called my blog.) My opinions can’t please everyone, of course, but – based on my experiences and understanding – I am certain that contributing some insights on health in light of our (all together now) genetic blueprint is a worthwhile and timely endeavor.

Now to the topic at hand. Stress can make you gain weight, and it contributes to premature aging. Understanding how stress is related to your overall health and potentially even longevity is essential to achieving your health goals. But do not, repeat, do not go and buy yourself a bottle of Cortislim – just read this quick summary and you’ll know all you need to know.

Eerie, ain't it?

Ariel Amanda Flickr Photo (CC)

The adrenal glands are not unlike a walnut.

Understanding Stress

Most folks are aware that “fight or flight” is the body’s natural response to stress. When faced with a stressful situation, we either get aggressive or, in the words of a local surf instructor, we bail. This choice depends upon our perception of the circumstances and our corresponding judgment of the odds of success. The “fight or flight” response is, in terms of energy preservation, tremendously efficient. And it is very effective at ensuring greater odds of survival. This makes sense to everyone on a visceral level, but do you know the physiological mechanisms involved?

The fight or flight response begins in the brain. Various regions operate in concert to detect, sense, decode, and respond to a stimulus. Though there are a few different pathways for a given feeling (like fear) to travel, it is ultimately the hypothalamus that is responsible for triggering the fight or flight response. Once the hypothalamus goes to work, what I call your survival systems, i.e. the “gut”, kick into gear. They are the nervous system and the adrenal-cortical system.

Enter physical symptoms: sweating, heart palpitations, muscles tensing, hearing sharpening. You are now extraordinarily alert, but only on the issue at hand: concentration and awareness of anything else fly out the window. The nervous system has flooded your body with adrenaline (scientists often refer to this as epinephrine) and noradrenaline (norepinephrine). Meanwhile, the adrenal-cortical system (which produces these hormones) becomes activated by way of the pituitary gland. The pituitary gland secretes a hormone known as ACTH (adrenocorticotropic hormone…say that three times fast). ACTH journeys – via the bloodstream – to your adrenal cortex, where these small organs will pump out as many as 30 different hormones to address the stressful situation at hand (the adrenals are “fed” by cholesterol). And your immune system temporarily shuts down so your body can utilize all its resources to deal with the perceived threat.

The adrenal cortex produces cortisol, DHEA, estrogen and testosterone, among many other hormones. It’s a beautiful system. Unfortunately, what worked for our old friend Grok does not, I believe, work so well for us. Simply put, our modern lifestyle subjects us to a potentially enormous amount of stress on a daily basis that the body has simply not evolved to handle. To my mind it’s a bit like “deer in the headlights”. We have a big deer overpopulation problem in my area, and you always hear comments along the lines of how dumb the deer are around automobiles. Well, in my opinion they’re not so dumb – in evolutionary terms, after all, cars are very new on the scene. The deer simply haven’t adapted the appropriate stress response. Is it so different for humans?

Theoretically then, persistent, low-level stress – which the body unfortunately interprets as warranting a “fight or flight” response – is destructive to health. In other words, being stuck in traffic for two hours a day, every day, is the equivalent of a serious survival threat to your as-yet “primal” brain, and the adrenals pump accordingly. Cortisol serves many important functions, including the rapid release of glycogen stores for immediate energy. But persistent cortisol release requires that other vital mechanisms effectively shut down – immunity, digestion, healthy endocrine function, and so on. Among other stress-health associations, the link between elevated cortisol and weight gain has already been established.

At this point I hope you can begin to imagine the potential health ramifications of what is often called “adrenal fatigue”: daily compromised immunity, continuous stress hormone release, being “on edge” generally, exhausted sex hormones (remembering my admittedly pet theory of why male endurance athletes often suffer from diminishing testosterone production and consequent receding hair). Your body thinks it must survive at all costs – and is there ever a cost.

Though I’m no Green, nor do I think moving to the woods to commune with the grubs is a viable (or desirable) solution to mitigating stress, the tremendous volume and scope of stressful stimuli present in the modern, fast-paced lifestyle may play a very critical role in the high rates of diabetes, metabolic syndrome, obesity, depression and anxiety we’re seeing (among many health problems). At any rate, I firmly believe this to be so. (Humorous note: apparently shopping is physically stressful for men. But then, planning holiday events and managing social obligations is stressful to women. At the risk of announcing my bah-humbugness to the world, the holidays are inordinately stressful to everyone.)

Managing Stress

Managing stress, then, is paramount to maximizing optimal health. To the extent that you can, reduce the “noise” in your life – from entertainment, from frivolous or excess obligations, from fractious relationships, from debt, and so on. Managing stress is a very big topic indeed, and we’ll be addressing it more in future posts. For now, here are the key factors I believe are necessary to reducing stress:

Consume antioxidant-rich foods such as fruits and vegetables. I also recommend a multivitamin that contains a comprehensive and potent antioxidant profile. Completely avoid processed, empty calories found in snacks, junk food and fast food.

Consume adequate beneficial fats to utilize antioxidants, vitamins, enzymes and co-factors. Wild Alaskan salmon, pure fish oil pills, olive oil, nuts and avocados are good places to start. I don’t go in for the Omega-enhanced Tropicana or miracle mayonnaise, personally.

Manage expectations: your own and others’. Ambition and motivation and generous support are all great traits to possess. But don’t over-promise to others or yourself. None of us knows the future.

Exercise daily. I cannot stress this enough. Exercise releases endorphins and helps to regulate the production of critical brain hormones.

Unhook daily. Most of us spend so much time on the input-output cycle, we don’t give adequate time to simply absorbing it all. Reflect, relax, restore. I personally like to spend a little time each day reflecting on what I am grateful for (I call this doing my “appreciations”.) Prayer, meditation, singing, cooking and other activities that get you out of your head and into the moment are vital to helping you manage the stress of constant stimuli and energy demands. “Think positive” is nice advice, but it’s tough to do if you are at your limit. It’s easier to find an action that naturally lends itself to positive thinking and feeling, rather than trying to control your thoughts. That in and of itself can become stressful. Find an immersing action that works for you and do it religiously. Fuming not recommended.

Further reading:

More Primal Health posts

Managing Stress: 10 Tips

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[tags] stress, adrenals, adrenal cortex, hormones, pituitary gland, hypothalamus, fight or flight, ACTH, adrenaline [/tags]

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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74 thoughts on “The Definitive Guide to Stress, Cortisol, and the Adrenals: When ‘Fight or Flight’ Meets the Modern World”

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  1. Hi Mark,
    I am so grateful for your newsletter… it makes perfect sense.
    I was diagnosed (finally) after several years of health problems and weight gain with cysts on my left kidney and adrenal gland… I have worked very hard to change my diet, no more chemicals, processed foods, organic as much as possible, no more wheat and very few starches (most of the time!). I am off all prescription meds, was even able to quit my high bp medication which was a biggie, since it tended to make me tired constantly. I have lost 75 pounds, and still would like to lose 75 more. When I went a month without losing weight, I began to work out daily, weights and treadmill. These last few weeks the weight loss has started again. My question is – I still feel the effect of the cyst on my adrenal glands, the jumpiness, heart palpitations, over-sensitive hearing… I sleep very little. I meditate, and have a gratitude time before I jump out of bed in the morning, and have cut nearly all caffeine out of my diet (except green tea in the morning). I no longer watch tv (had direct tv disconnected, only occasionally catch up on the news, am learning how to rephrase negativity in my life in positive ways…What else can I do?
    Thanks so much for any suggestions you can give me!
    I am now experiencing thinning hair (not great for a woman!)

    1. I know this was posted about 3 years ago but would like to reply anyways.
      I’ve had heart palpitations my entire life. In fact, my heart would ache several times a year and mimic a heart attack. My entire left side of my upper body would be in so much pain I had to lift my left arm up to drain the blood.

      And I had all this while weighing 135 lbs at 5’10” (female).

      Finally by age 35 I had an allergy test done (outdoor stuff) and got allergy shots…which completely got rid of the heart palpitations but not the “mimicing” of heart attacks. Then I found MDA, started eating primal and upped my saturated fat intake. It’s been 1 year and I’ve had 2 of those little heart attack episodes (never actually went to a doctor to get it checked out, of fear they’d find something bad). Those 2 little “heart attacks” were not as severe and happened at the beginning of going primal…and have completely stopped now. No more heart pain, palpitations or mimicing heart attacks.

      Just recently I’ve read an article stating that the heart muscles energy comes EXCLUSIVELY from saturated fat.
      A light bulb came on….

      1. Hi Donnersberg, I am happy to hear that the primal diet is working for you as well. I used to have the heart problems too; and no wonder, considering that I used to follow the “low-fat” diet that CW is preaching. Your post just reminded me that I also have stopped having these heart problems after I had been primal for about 6 months or so. Have been primal for about 12 months now but I am still trying to recover from the adrenal dysfuntion. A slow process but I am making progress. I am hoping to give Mark a success story by the end of this year :o)

      2. I’ve had heart palpitations my entire life. In fact, my heart would ache several times a year and mimic a heart attack. My entire left side of my upper body would be in so much pain I had to lift my left arm up to drain the blood.

        I know this is an older thread but I have these exact same heart issues. In fact, last year I thought I was having a heart attack and went to the hospital. They did all the tests, even an angioplasty, but they said that it wasn’t a heart attack; although my left heart chamber had less than 10% blockage which they said was common. They put me on a low fat diet. My heart palpitations still persisted.

        Anyway, I discovered the whole Paleo/Primal scene in December and it has taken me about 6 months to digest it. I am one month into a paleo/primal diet and I am losing weight and feeling better but I still do get those heart palpitations from time to time.

        Has anyone else experienced this? If so, what helps to alleviate or eliminate this?


        1. Hey, another thing that can cause this heart attack mimicking is the ‘coccidiosis virus’ and it can infect the heart. I had it, and my functional medicine doctor, who was formerly head of cardiology at a nearby hospital, cured me of it somehow without using antibiotics of any kind. Something to think about. You can Google more about it and find out more… Hope you are still around?

    2. Hello you and I have a similar issue. I have a rare form of benign spinal tumor, likely caused from spinal trauma inflicted by an anesthesiologist. Up from the tumor runs a cyst as well. I also have pressure on adrenal nerves. The tumor is pressing on my leg nerves and they don’t work. No amount of wishing or therapy is going to change the fact that when the nerve is damaged or pressure is applied that it can cause problems and I see the same issue with the adrenals. That being said, I’d suggest following up with an endocrinologist or two. If the cyst is pressing the nerves, it can cause system disruption that no amount of positive thinking or diet changes will help (though I’d recommend both as well).

      You can start with an at home coritsol test, it should give you an idea of how coritsol is running. Other levels need to be serum tested in a lab, thyroid, glucose, etc.

      I have a perfect running body system and am young, so I’m a fairly good control. Perfect organs, bp, nutrients, etc. The low coritsol from the adrenal fatigue made it so I had no energy to even handle basic life issues. It’s something that has to be regulated. If you have trouble with docs, please don’t loose heart, it’s a complicated issue and will take time to resolve.

      Best wishes.

    3. Dear Mark,

      I just want to applaud you on your blog and the amount of precious information you make available in a clear and structured way. Bravo!!
      I’m glad I came across your blog and have spent hours reading many of your posts in the last week. I’m a physician myself and will totally use these concepts when trying to help patients (almost all…) with metabolic issues.
      Thank you!!

  2. Hi Mark,
    I have only just found you after doing extensive research on the internet to find ways to cure myself. I have been on the decline for years. First I was told that I was hypothyroid and I have sooo many health problems. Too numerous to mention. Now it also appears that I have adrenal fatigue. It has taken many visits to the doctor before he would even listen to me and do the tests. Now I have to work out how to get back on track. I have been trying to read as many articles of yours as possible. So far they have been very helpful 🙂 I guess there is no quick way to solve all of my health problems, and reducing my stress levels would be almost impossible in the life situation I am in. I will try your primal diet and do the best I can. Hopefully it will not take too long before I can even do the simple things again (like get up the stairs to my house). I am a type O blood type and I love to do exercise (especially martial arts). The fact that I have been too weak and exhausted to do so has also caused a great deal of depression.
    Thank you for your newsletters.

    1. Hi Angelina,
      Reading your comment was like having you talk about my life this past year. I’m a long distance trail runner, and now I can’t even hike. The diagnosis started with autoimmune hypothyroidism, then adrenal stress, now autoimmune diabetes. I’m seeing integrative doctors and they put me on all sorts of supplements as well as Armour and Cortisol, but my energy level is still extremely low. And not being able to run is causing me severe depression. I eat very healthy – mostly organic greens, a little fruit and organic meat…no carbs since my body can’t handle it. Please let me know if anyone has any suggestions. I need help to get out of this. Thank you. Anny

      1. Hi Anny, I WILL get back to you after my exams :o) I have kept with the primal diet and I am seeing some improvements. It is a slow process though…and I have kept the carbs really low, stayed very strict, and increased fats. I have also been taking herbs and vitamins that provide adrenal support and taken lots of rest. One of the important things is also to remove some of the things in your life that might be causing you stress and also don’t over-exericse…and get lots of sleep. I also gave up fruit because of the fructose..For the first time in two years I was able to do 3 miles on my exercise bike…but would still be no good at running up and down hills etc. I did start reading a book a couple of weeks ago that might be of interest to you called Chi Running by Danny Dreyer. If you get the 2009 edition from it is a full revised edition that starts with Chi Walking and will guide you on how to run effortlessly without strain or injuries…
        Will get back to you after my exam..
        Best Wishes.

      2. You may have Lyme Disease. I got bit about 6 years ago by those large animal-biting flies you see on dairy farms. The Lyme is very hard to detect. You need a doctor who believes Lyme exists.
        My fatigue was awful along with serious depression. I could barely function. I also had headaches and involuntary tremors and pain in my arms and legs. Lyme is very tenacious and difficult to treat. It mimics other sickness and disorders. You really need to find a good lyme doctor if you want to check that out.

        1. I was diagnosed 3 years ago with late Stage Lyme Disease. As near as I can figure, I was probably bitten somewhere between 1985-88. There came a point when I could no longer go camping or walk long distances, so that’s aprt of how I know, plus remembering a tick bite that my MD ignored. Since I was in school and working full time I thought my problems were due to stress. My MD said I was just getting older. (40?) Finally, after 9 years of watching pain and neuropathy creep up both legs, I got scared when it started in my arms. I complained to my sympathetic gyn and she did tests, which showed Lyme and Epstein-Barr. My CD 57 was 22, which showed how sick I was. My Vitamin D level was 9. She said I was barely a carbon-based life form…lol! After 3 years of antibiotics, my asthma has gone away. I’m hoping my Hashimoto’s and insulin resistance will go away, too. For 16 years I was an EMT, working in the E.R. and pretty strong. Now I feel lucky to have escaped with my life and most of my mind. I take Paracetim for memory loss, and supplements to help with Lyme neuropathy. I hope you are feeling better now.

  3. Mark, someone commenting on another blog has been saying that too much protein raises cortisol (I get that it can raise insulin, but cortisol?) and gives this as a reason low-carb is supposedly bad for the metabolism. She also claims that insulin is anabolic and so needs to be balanced with cortisol, which is catabolic. It sounds off to me, but hey, I’m no endocrinologist. This all came up in the context of Jimmy Moore announcing he’s eating just eggs, butter and cheese for the time being to reverse his recent weight gain. Apparently his metabolism is so broken that even limiting himself to 30 or so grams of carbohydrates a day is not enough to stop weight regain. He also says he’s breaking his diet soda habit at long last.

    So my question, is there any truth to the assertion (by Matt Stone and others) that low carb could actually damage your metabolism? Even if you’re eating moderate protein, high fat? Thanks for any light you can shed on this.

  4. I believe a diet that is too low in carbs would certainly lead to an increased cortisol level and maybe weight gain. This would be especially true with females. My female friends who do low carb always complain about this. As soon as they add 10 to 20 more carbs everyday the weight starts coming off and they feel better. Then again some people feel fine on an all meat diet. I know that I do better with almost no carbs.

    1. I agree that it is still an individual thing too. I have also heard that females do better with a little more carbs than the men. But I have always thought my system ran more like a males, and it appears that I was right. I also had some tests done not long ago and my doctor, to my surprise, said “your more like a male”. I tried to eat just a little extra carbs and it was doing me no good at all. I cut them out almost entirely and now I am starting to slowly get better from all of my above health problems. We are certainly all individuals!

      1. New reply to old post.
        I have thought for awhile that females needing somewhat more carbs may be due to the hunter-gatherer lifestyle itself. I am sure that Grokka ate some of the plants as she gathered them so she didn’t need to develop the means to turn protein into carbs as much as the hunting males did. I need SOME carbs but the slower the better; cut them back too much and I am fighting w/hypoglycemia. If I eat fruit for/with breakfast I have cravings all day; can’t get satisfied by whatever I eat.
        Looking forward to finding out more about the effects of cortisol.

        1. I had similar issues with eating fruit & making me extra hungry after. No matter how I balanced my meals/snacks with protein/carb/fat the fruit set off my appetite! I’m studying to be a Registered Dietitian and currently specialize in IBS/thyroid/adrenal related issues. I wanted to let you know what I found after tons of self study into my imbalances that caused chronic hunger & hypoglycemia. By way of speciality testing: spectracell (nutrients intracellular), MRT Leap 150 (food sensitivities/chemicals), & comprehensive stool analysis test (gut flora balance) I saw inside what was out of balance do I could rebalance.
          I had a candida/yeast/wheat/dairy/and a fair amount of other offending foods, a severe imbalance in my gut flora, even after being primal/gluten free/dairy free I had some major nutrient deficiencies due to gut flora effecting my enzymes & ability to absorb nutrients, chromium was very low (hypoglycemia & sugar cravings, calcium, vitamin D (even after 2 years, of supplementing with 2,000 iu, now I take 5,000), a couple amino acids, zinc, so my adrenals were off= thyroid off (hypothyroid), digestion was off (Candida albicans) but after a month of avoiding candida feeding foods (only very small portions of low sugar fruits), digestive enzymes/probiotics/cultured veggies/vitamins where I tested extremely low/fresh real food cooked daily/avoidance of moldy foods/adrenal supplement/modified daily exercise/and stress reduction BALANCE is coming back & I can eat potatoes/fruit with my main meals and feel energized/satisfied/stable. It takes self discovery, & maybe some special antifungal a if candida or parasites are wrecking your gut flora
          “Food is Medicine”

  5. This blog has excellent information and confirms much of what I was clued. Please continue to post great information as I am a reader who values it, because I’m trying to lose weight (I use to lose easily) and get healthy again. 30 lbs. to go….off and away.

  6. Thanks for writing this.

    1) You recc. exercising daily. However, didn’t we also agree that you shouldn’t exercise daily (overtraining article)?

    2) Isn’t baldness caused by DHT, which is related to testosterone? ie: Wouldn’t it be: HIGH stress -> low testosterone -> less DHT -> LESS bald ?

    1. I think by ‘exercise’ he means just moving the bones in general…not actually sweating your armpits off doing cardio.

      Means don’t get up in the morning and schlepp yourself to the couch where you remain watching TV until bedtime.

      Taking the dog for a walk, go to the park, walk around the mall and check out the newest silly outfits, play ball, rollerskate, go swimming, even going to the library and read a couple pages of books of interest without sitting down.
      I personally love going to the outdoor hot tubs, the smell of sulfur and slimey mineral water on my skin is so refreshing 🙂

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  8. I am interesting in following your exercise recommendations, but for someone who already has adrenal fatigue, what is the best approach? Intense exercise (such as lifting heavy weights or sprints) really whacks me, and it seems like it would just put more stress on the adrenals? Would you tweak your recommendations in this case?

  9. I struggle with unusually low cortisol in the am and normal high at night. Paleo diet helps but I want to have better mornings and recovery adrenals. Ideas?

  10. Hi there, I found your web site by way of Google even as looking for a comparable topic, your site got here up, it seems to be good. I’ve bookmarked to favourites|added to my bookmarks.

  11. Great article.

    I’ve been going through tons of cortisol tests, been having all kind of issues for over a year, cortisol is definately somehow related to it. My levels are pretty high, just not sure of the source.

  12. High carbs rises insuline which antagonize cortisol.

    High carbs may rises sugar in the blood which reduces cortisol need and production.

    Low carbs requires proteins and fats to be used for energy which increase need and production or cortisol.

    Cortisol is not evil. It’s the base hormone for energy, well being feeling and good mood.

    If cortisol is low sugar in blood is low and the body produces more adrenaline and noradrenaline to keep going, which creates anxiety.

    Cortisol doesn’t produce anxiety. It reduce the hormones which create anxiety such as adrenaline and noradrenaline.

    Cortisol gives You calm energy, comfortable body feeling, sense of well being, good mood, relaxation, motivation and clearness of mind.

    1. i believe the point is that a relatively level amount of cortisol is essential to our well being and is critical to our existance but SPIKES aren’t and chronic elevated levels are adverse to our health. Also the longer and more frequent
      the spikes and sustained elevated levels exist the harder it is for our bodies to produce when necessary. Coffee junkies.People who need 6 cups of coffe a day to function. plus chocolate derived and cola derived and jolt type drinks. Personally i gave up caffeine since i got tired of waking up feeling like i needed a cup of coffee. Now i wake up feeling rested. Haven’t hit the snooze button in years. Really don’t need the alarm clock either. LIke when i was a kid before i knew what caffeine was.

  13. It surprises me that you, of all people, limit stress to fight or flight… why does no one ever mention “freeze”?

  14. I’m looking for more Information on adrenal problems and cortisal. I’ve been fighting the fight for 9 years, have realized that due to high stress my body has taken on its own way. I’ve been to every doctor imaginable these last 9 years, I have had so many tests and yet me symptoms still exist. I’ve kept a log and done extensive research which has lead me here. I recently have gotten worse with digestive problems and pain in my upper central abdomen, my joints have gotten increasingly more stiff, i have had mood swings, my muscles are consistently tense and I have been experiencing consistent nassau for 3 months now. My symptoms before this were brain fog, heart palpatations, headaches, and shakiness. I’ve recently started a raw foods approach, and am considering getting a test done to check my cortisone levels as I’m concerned it may be a problem with my adrenal glands. If anyone has a external take on my situation I would love to hear some feed back. Thank you.

    1. This is a very late post to your health issues, but im a nurse and I have lyme disease and everything you are describing in your post points toward lyme disease. And just so u know if you’re blood test came back negative that doesn’t mean you don’t have lyme. Majority of the blood test come back false negative unless you have Igenx Labs which is a lab in California that specializes in tickets borne illnesses. It isn’t just lyme its all the confections that go with it also.. Lyme destroys your adrenal glands and its all downhill from there. Been suffering for five years now. There is no cure only thing that helps is diet/lifestyle changes and supplements. Some people get better from antibiotics but then relapse again. It’s a very difficult disease it fight. And an expensive one. Go to lyme there are many lyme sites out there just make sure you go to a legitimate one and make sure you see an LLMD or a naturopath that specializes in lyme.

      1. Hang on… if your adrenals are “destroyed” for any reason you should go to an endocrinologist and get replacement cortisol because it is deadly to have none in your body. A naturopath that is not an MD (some are) cannot prescribe it or diagnose it, and the condition is lethal. Lyme may be a serious issue by itself, but if you suspect your adrenals are really non-functional, medical help is the first answer, and THEN you can seek alternatives to help your quality of life.

    2. “My symptoms before this were brain fog, heart palpatations, headaches, and shakiness.”

      I had these symptoms and many more as i have been dealing with numerous health issues for 5 years now. Tons of doctor visit and tests revealing nothing to go on, took matters into my hands. Found a holistic chiropractor and with some testing, revealed many of the unmentioned health issues but the biggest one that contributed to these symptoms was 10 times off the chart high levels of toxicity such as mercury, copper and 4 types of parasites. It made sense why my adrenals were exhausted and my cortisol through the roof. My body had been fighting for my life day in and day out.
      I have been blogging a little bit but had to stop as I am still working on recouping my adrenals. Everything else, i can finally say is history.

      I truly hope you find your cause!

    3. Jaime, I don’t know if you’re still following this, but I totally agree with what Angie wrote.

      While it isn’t conclusive, all of your symptoms are consistent with Lyme and bartonella infections – get yourself checked out by an ILADS Lyme-literate doctor (LLMD).

      My oldest son went untreated for years, the nutritional & holistic approaches we tried helped some, but did not get rid of his symptoms, then he was exposed to mycoplasma pneumoniae from one of his siblings & became almost completely dysfunctional (Lyme & bart cripple the immune system). He is only now beginning to find relief – and we hope eventually healing.

  15. I find the Terry Wahls diet good for my adrenal insufficiency:

    Not all fruit is the same either.

    Mark, would be nice to see a blog that covers fruit indepth, with regards to which sugars are glucose dominant and which are fructose dominant.

  16. You cannot believe just how sick adrenal fatigue can make you. It has completely knocked out all of my organs. I am now getting back on my feet after six hellish years. I actually could go on and on here, but it’s enough to say..take care of your adrenals or you won’t believe what happens to your will actually lose it if you’re not careful. I know.

    1. +1 You said it! Ten years of abuse and my adrenals said “enough”… I was literally carried out of the office on a stretcher. Had every test Kaiser could throw at it and was told I was healthy. Right! Thank goodness for alternative health practitioners who could empirically determine (24hr cortisol test, for instance) what the issue was. And diet and sleep DEFINITELY makes a difference.

  17. my chest becomes heavy especially in the morning so waht should i do to avoid this

  18. Finding your pages very helpful and interesting, thanks!

    There is just one thing that troubles me (but that I don’t expect you to have an answer to): Assuming primal/paleo really is the healthiest way for humans to eat (a bit of a blow for vegetarians all over the world), there is one large-scale problem: the world is unable to feed its population on such a high-meat and high-quality diet. From a well-off, American/Western perspective, it’s possible to obtain and pay for these foods, but it takes about 10 times as much land to feed someone on beef compared to grain (figure may be slightly off, but you get the idea), and there is a real problem with this: in today’s world, this kind of diet is destined to remain the privilege of the lucky few.

    The only solution is people having (a lot) less children. Our friend Grok did not have this problem, of course, the lucky sod.

    On a more practical but related note, what adaptation would you suggest for someone who is vegetarian and wants to follow the PB? Would tofu be acceptable?

    I also don’t quite understand what the problem with pulses and grains like quinoa is (according to paleo), as I thought they were quite a good source of protein.

    Any answers/suggestions would be much appreciated!

    1. quinoa also results in intestine perforations so has the same net effect regarding, immune response,inflammation,etc as grains do.
      Our social structure is based on grain agriculture. Grains being a hedge against hunger and also a political tool was fundamental in the creation of city dwelling. Large populations requiring far less land per person to susist than the hunter gatherer socities that preceded the agricultural revoltion.
      Paleo diet is 50% vegetables, 25% meat, 25 fruit, nuts, berries, misc.
      Tofu being a soybean derived food is the same as any legume. Lectins and saponins are the villians, according to Paleo.
      The book, “Paleo Solution,” by Robb Wolf, 20 year former vegetarian, who degree is in biochemistry has an interesting perspective. My favorite of the 1/2 dozen or so Paleo books i’ve read.

  19. Mark,
    This is one of the most incredible posts I have ever read. I am a college student, currently in finals week. I can’t think of anything better than this to read! Thank you for your advice, and keep up the great work! It is appreciated more than you know!

  20. How does this affect someone with hypopituitarism and are there any extra things they need to do to manage/minimize this?

  21. Great write up, thanks. This has really helped me out.

    On the point of people complaining about “lack of a thientific approach”, here’s a little open source stock answer to copy-paste next time:

    Dear human.
    Thanks for your perspective. As a human myself, I also have perspectives, all of which are shaped by my human experiences. This is comes through in my writing. The best way for you to read what you want to read is to write it yourself.

  22. Another possible source of too much cortisol–chronic pain. I am thinking that my chronic pain (ruined feet that hurt 95% of the time) is overstimulating me, which is why no matter how I adjust my diet my belly (my waist/hip ratio varies from 1.0 to 1.1) refuses to get any smaller (female ratio thould be .80 or less).
    Input appreciated

  23. Hi Mark,
    Good article on adrenal fatigue. One thing you didn’t mention is the relationship between allergies and adrenal fatigue. The adrenals become stressed not just from emotional stress, but also physical stress, and allergies are a major source of physical stress on the body. I had a case of undiagnosed gluten allergy for years which caused severe adrenal fatigue and all the other associated problems (digestive & nervous system disorders, hormone imbalance, thyroid problems, etc.). I would recommend that anyone with adrenal fatigue get the blood test for food allergies.

  24. “Reflect, relax, restore. I personally like to spend a little time each day reflecting on what I am grateful for ”

    Yaaaawwwwnnnn… honestly I think it’s time we woke up to the fact that advice on this subject is seriously dull. How about this? Go to youtube and find your favorite song from when you were about age 14-16… then find similar songs… if you’re lucky like me, you grew up during the birth of MTV and you’ll find those old music videos. Groove on those, but make a list. A playlist for a CD you will play while vegging out later.

    Oh yeah… I’m grateful that I grew up in such a great time to be a kid.

  25. Its like you read my mind! You appear to know so much about this, like you wrote the book in it or something.
    I think that you could do with a few pics to drive the message
    home a little bit, but other than that, this is great
    blog. An excellent read. I will certainly be back.

  26. Hello. I really enjoy all the info on healthy eating and I do do better in less carbs. I am 59 yrs old and have about 10 to 15 lbs to lose. Last June I started having acid reflux and I had an endoscopy in Jan. I take Ranidine. I still have to watch what I eat. So what do you recommend as far as fats since u don’t process them as well ( I also have my gall bladder removed).

  27. Hi Mark,
    Good article on adrenal fatigue. One thing you didn’t mention is the relationship between allergies and adrenal fatigue. The adrenals become stressed not just from emotional stress, but also physical stress, and allergies are a major source of physical stress on the body.