Understanding the Adrenals: The System Behind Stress, Energy and Burnout

​The adrenal glands are small, about the size of a walnut. They sit quietly on top of your kidneys and are rarely mentioned in routine check-ups. Most people have never given them much thought.  And yet, these tiny glands play a central role in how you feel every single day.

They influence your energy levels, your ability to cope with stress, your blood pressure, blood sugar balance, immune system, sleep, metabolism, hormone production and even your body’s fluid and electrolyte balance. In many ways, they determine how well you are able to meet the demands of daily life.

When your adrenal glands are working well, you tend to wake feeling refreshed. You cope with stress more easily, recover quickly, sleep deeply and move through your day with a steady sense of energy and resilience.  When they are not functioning as they should, things begin to unravel. At first it may be subtle. Over time, it can affect almost every system in the body.

To understand why this happens, it helps to understand what the adrenal glands are and what they do.

What are the adrenal glands?

You have two adrenal glands, one sitting on top of each kidney. Although they are small and only weigh a few grams, they are incredibly complex and play a vital role in hormone production.  Each gland is made up of two distinct parts, both with very different functions.

The outer layer is called the adrenal cortex. This makes up the majority of the gland and produces steroid hormones from cholesterol. These include cortisol, which helps regulate your stress response, blood sugar, metabolism and immune system.  It also produces aldosterone, which controls your sodium and potassium balance, blood pressure and fluid levels.

In addition, the adrenal cortex produces androgens such as DHEA and DHEA-S. These are precursor hormones that can be converted into testosterone and oestrogen. They are important for energy, muscle strength, libido and overall vitality.

The inner part of the gland is called the adrenal medulla. This acts more like part of the nervous system and produces adrenaline and noradrenaline. These hormones are responsible for your immediate response to stress or danger, often referred to as the fight or flight response.

The outer part of the gland responds to signals from the brain, particularly from the pituitary gland. The inner part responds directly to the nervous system and can activate within seconds.  Together, these two areas allow your body to respond to both immediate challenges and longer-term demands.

The key adrenal hormones and what they do...

To understand adrenal health properly, it is important to look at the individual hormones and what they actually do in the body.

Cortisol is often referred to as the main stress hormone, but it does far more than that. It follows a natural daily rhythm. It should rise in the morning to help you wake up and feel alert, then gradually fall throughout the day, reaching its lowest point at night to allow for sleep.

When this rhythm is working well, cortisol helps you wake with energy and clarity. It supports stable blood sugar by releasing stored energy when needed. It helps regulate inflammation, sharpens focus when you are under pressure and plays a role in maintaining blood pressure and fluid balance.  

Cortisol gets a lot of bad press, but it is not harmful in itself. In fact, it is essential for life. The problem arises when it becomes dysregulated over time.

Aldosterone is responsible for maintaining fluid balance and blood pressure. It works by signalling the kidneys to retain sodium and release potassium.  When adrenal function is compromised, aldosterone levels can drop. This can lead to low blood pressure, particularly when standing up, which may cause dizziness. Many people experience strong cravings for salt, which is the body’s way of trying to correct this imbalance. There may also be increased thirst, more frequent urination and general fatigue or weakness due to disrupted electrolyte balance.

These salt cravings are often misunderstood, but they can be a very real physiological signal from the body.

DHEA and DHEA-S are produced by the adrenal cortex and act as building blocks for other hormones, including testosterone and oestrogen.  They also have important roles of their own. They help regulate inflammation, support brain function, influence mood and contribute to energy levels, motivation and libido. They act as a natural counterbalance to cortisol.

Levels of DHEA are highest in early adulthood and naturally decline with age. However, long-term stress can accelerate this decline significantly. It is not uncommon to see people in their thirties with levels more typical of someone much older.  Low levels of DHEA-S on blood tests are often a sign that the adrenal system has been under prolonged stress.

Adrenaline and noradrenaline are fast-acting hormones produced by the inner part of the adrenal glands.  Adrenaline prepares the body for immediate action. It increases heart rate, opens up the airways, raises blood sugar and redirects blood flow to the muscles. It heightens awareness and reaction time.

Noradrenaline helps sustain this response. It raises blood pressure by narrowing blood vessels and plays a key role in maintaining focus, attention and motivation.

In situations of ongoing stress, these systems are activated repeatedly. Over time, this can contribute to depletion of the neurotransmitters needed to produce these hormones. This is one of the reasons why people experiencing long-term stress often feel exhausted, mentally drained, low in mood and lacking motivation.

The adrenal spectrum: from optimal function to depletion
Adrenal health is not simply a case of being either “fine” or “not fine”. It exists on a spectrum.  Where someone sits on that spectrum will influence how they feel, what symptoms they experience, what their blood tests show and how long recovery may take.  Most people move gradually along this spectrum over time, often without realising it.

Stage 1: alarm and mobilisation
In the early stage, the body is responding to stress by producing higher levels of cortisol to meet demand.  At this point, many people actually feel quite capable. They may feel driven, alert and productive. Some describe feeling “wired”, always on the go, and able to push through long days.
Sleep may be lighter, and there is often a reliance on caffeine to keep going. Many people feel most energised when they are under pressure.  Behind the scenes, however, the body is prioritising cortisol production. As a result, DHEA, which supports energy, mood and hormone balance, begins to decline.
This stage can last for months or even years. It is very common in high-performing individuals and is often mistaken for simply being busy or motivated, rather than a stress response.

Stage 2: resistance
In this stage, the body is still coping, but signs of strain begin to appear.  Cortisol levels become less stable. They may be high at certain times and then drop unexpectedly at others.  The normal morning rise in cortisol, which helps you wake up, becomes weaker. Waking can feel difficult and unrefreshing. Energy often dips in the afternoon, leading to crashes.  Sleep may become more disrupted, mood less stable, and cravings for sugar and caffeine tend to increase.
The immune system may also begin to struggle. People often notice they are picking up infections more easily or taking longer to recover.  DHEA levels have usually declined further by this point. A common observation is that the body no longer bounces back from stress, illness or exercise in the way it once did.

Stage 3: exhaustion and dysregulation
At this stage, the body’s stress response system has lost its normal rhythm.  Cortisol patterns can become very irregular. Levels may be low throughout the day, or there may be a reversal where cortisol is low in the morning but rises at night, making it difficult to sleep.  
The usual daily pattern becomes flattened or unpredictable.  Symptoms at this stage are often more noticeable and can affect multiple areas of health.  There may be deep fatigue that is not improved by rest or sleep. Even small stresses can feel overwhelming. Blood sugar becomes unstable, leading to shakiness, irritability or feeling faint between meals.
Low blood pressure is common, particularly when standing up, often accompanied by dizziness. Cravings for both salt and sugar can become intense.  The immune system tends to weaken, with frequent infections or slow recovery. Mood can be affected, with low motivation, flatness or symptoms of depression.
Cognitive symptoms such as brain fog and poor memory are common. Hormones may also be affected, leading to low testosterone, disrupted menstrual cycles and reduced libido.  Many people also become more sensitive to light, noise and general sensory input.
A common pattern is feeling more alert late at night, even though this is when the body should be winding down.
This stage is often referred to as adrenal fatigue. Although this term is not formally recognised in conventional medicine, it reflects a very real pattern of dysregulation within the stress response system. It sits below conditions such as Addison’s disease, but can still have a significant impact on quality of life.

What disrupts adrenal function
To support the adrenal glands properly, it is important to understand what places them under strain in the first place.  Addressing these underlying factors is key. Otherwise, you are only managing symptoms rather than resolving the cause.
Physiological Stress: Chronic psychological stress is one of the most significant drivers. Ongoing pressures such as relationship difficulties, financial worries, work demands, perfectionism, people-pleasing and unresolved emotional stress all keep the body in a prolonged state of alert. Over time, this places a continuous demand on the adrenal system.
Blood Sugar Imbalance: Blood sugar imbalance is another major factor. Every time blood sugar drops too low, the body must release cortisol and adrenaline to bring it back up. Diets high in refined carbohydrates, irregular eating patterns, skipping meals or prolonged fasting in an already stressed system all increase the demand on the adrenals throughout the day.
Caffeine: Excessive caffeine can also contribute. Caffeine stimulates the release of adrenaline. In someone who is well-rested, occasional use is usually well tolerated. However, in someone already under stress, it creates a temporary boost at the expense of further depletion.  A common pattern is needing coffee to feel functional in the morning, followed by anxiety, irritability or a crash later in the day.
Over-training: Exercise is another important factor. Movement is beneficial and supports resilience when balanced with proper recovery. However, excessive high-intensity training without adequate rest can increase cortisol levels and place additional strain on the adrenal system. In someone already depleted, this can make things worse rather than better.
Poor Sleep: Sleep is essential for recovery. Much of the body’s repair and regeneration takes place during sleep, particularly in the earlier part of the night. Poor sleep, disrupted sleep or consistently going to bed late reduces the body’s ability to restore adrenal function and can disturb the natural cortisol rhythm.
Nutrient Depletion: Nutrition also plays a critical role. The adrenal glands have high nutritional demands and require adequate levels of key nutrients to function properly.  Vitamin C is particularly important, as the adrenal glands use large amounts of it during stress. B vitamins, especially B5, B6 and B12, are needed for hormone production. Magnesium supports many processes in the body, including the regulation of stress hormones. Zinc plays a role in both immune and adrenal function. Sodium and potassium are essential for fluid and electrolyte balance. Cholesterol is also needed, as it is the building block for adrenal hormones.
Deficiencies in any of these nutrients, which are common in modern diets and in people under long-term stress, can impair adrenal function and slow recovery.
Infections: Chronic infections and ongoing inflammation can also place a significant burden on the adrenal glands. Conditions such as gut imbalances, parasitic infections or long-term exposure to mould can keep the immune system constantly active. The adrenals are then required to continuously regulate this inflammatory response.
Medications: Certain medications can affect adrenal function as well. Long-term use of steroid medications, such as prednisolone or hydrocortisone, can reduce the body’s own production of cortisol. Over time, this can suppress the adrenal glands and requires careful medical supervision if adjustments are made.
Emotional Upset: Finally, emotional trauma can have a lasting impact on the stress response system. Past experiences, particularly from earlier life, can keep the nervous system in a heightened state of alert, even when there is no immediate threat. This ongoing activation can be measured in changes to hormone patterns, inflammation and overall health.

How to genuinely restore adrenal health
Recovering from adrenal dysregulation is absolutely possible. But it is not about quick fixes or simply adding a few supplements on top of an already demanding lifestyle.
This is about creating the right conditions for the body to repair.
The adrenal glands do not need stimulation. They need support, nourishment and space to recover.

Start with the foundations
One of the most important aspects of recovery is understanding that the body will not heal if it is still under constant pressure.
If the underlying drivers of stress remain in place, the adrenals will continue to compensate, no matter how many supportive strategies are introduced.
This means taking an honest look at what is placing ongoing demand on your system. This could be emotional stress, work pressures, unresolved trauma, or simply a lifestyle that does not allow for rest.
True recovery often involves making changes at this deeper level. In some cases, additional support such as counselling or trauma-informed therapies can be incredibly helpful in calming the nervous system and reducing this ongoing load.

Sleep is where recovery begins
There is no substitute for sleep when it comes to restoring adrenal health.
Much of the body’s repair work happens overnight, particularly in the earlier part of the night. If sleep is poor, fragmented or consistently cut short, recovery will be limited.
Aim for sufficient, consistent sleep each night, ideally getting into bed earlier rather than later. A calm evening routine, a cool and dark bedroom, and reducing screen exposure before bed can all make a significant difference.
Supporting the nervous system to wind down in the evening is key. Nutrients such as magnesium can be helpful for some people, particularly if sleep is light or restless.
If waking in the early hours is an issue, this is often linked to blood sugar or cortisol patterns and needs to be addressed more broadly.

Balance your blood sugar
One of the most overlooked but essential aspects of adrenal recovery is keeping blood sugar stable.
Every time blood sugar drops too low, the body must release stress hormones to bring it back up. This places additional demand on the adrenal glands throughout the day.
Eating regularly is important, particularly during the recovery phase. Skipping meals or prolonged fasting can make symptoms worse.
Starting the day with food, ideally containing protein and healthy fats, helps to set a more stable pattern for the rest of the day. Each meal should aim to include a balance of protein, fats and fibre to avoid spikes and crashes.
Reducing refined sugars, alcohol and highly processed carbohydrates is also important, as these tend to create the fluctuations that drive stress hormone release.

Rethink your relationship with caffeine
For many people, caffeine feels essential, especially when energy is low.
However, caffeine stimulates the release of adrenaline and can place additional strain on an already depleted system. It often creates a temporary lift followed by a crash, reinforcing the cycle.
If reducing caffeine feels difficult, that in itself can be a sign that the body is relying on it.
Gradually cutting back is usually more manageable than stopping suddenly. Some people find it helpful to delay their first cup of the day, allowing the body’s natural morning rhythm to establish itself first.
Replacing coffee with gentler alternatives, such as herbal or adaptogenic drinks, can also support this transition.

Support the body nutritionally
The adrenal glands have a high demand for nutrients, particularly during periods of stress.
Ensuring a diet rich in whole, nourishing foods is essential. Key nutrients involved in adrenal function include vitamin C, B vitamins, magnesium, zinc and adequate electrolytes such as sodium and potassium.
It is also important not to overly restrict salt during this time, especially if symptoms such as dizziness or salt cravings are present.
Healthy fats and cholesterol-containing foods also play a role, as they provide the building blocks for hormone production.
In some cases, targeted supplementation may be appropriate, but this should always sit alongside a supportive diet rather than replace it.

Use herbs wisely
Certain herbs, often referred to as adaptogens, can be helpful in supporting the body’s response to stress.
Rather than forcing the body in one direction, they help to bring balance to the stress response system.
Different herbs can be more appropriate at different stages. Some support calming and sleep, others support energy and resilience.
They tend to work gradually over time rather than providing an immediate effect, and consistency is key. They should be seen as supportive tools rather than quick fixes.

Match exercise to your current capacity
Exercise is beneficial, but the type and intensity matter.
High-intensity or prolonged exercise places a demand on the stress response system. For someone already experiencing adrenal strain, this can make symptoms worse, even if it feels beneficial in the moment.
During recovery, gentler forms of movement are often more appropriate. Walking, stretching, swimming or slower-paced practices can support the body without overwhelming it.
A useful guide is how you feel afterwards. If exercise leaves you feeling drained for hours, it is likely too much at this stage.
As energy improves, intensity can be gradually increased.

Calm the nervous system
The adrenal glands are closely linked to the nervous system. If the body remains in a constant state of alert, recovery will be limited.
Practices that help shift the body into a more relaxed state can have a powerful impact.
Simple breathing techniques, particularly those that focus on a longer exhale, can help activate the body’s relaxation response.
Spending time outdoors, especially in natural light, supports the body’s internal rhythms. Even short periods outside can make a difference.
Gentle practices such as yoga or guided relaxation can also help reduce the overall stress load on the system.

Understand the connection with the thyroid
The adrenal glands and the thyroid are closely connected, and it is important to consider both together.
Cortisol plays a role in how thyroid hormones are used in the body. If cortisol levels are not balanced, the body may not respond properly to thyroid hormones, even if levels appear normal on tests.
At the same time, an underactive thyroid can place additional strain on the adrenal glands.
For this reason, supporting adrenal health is often an important part of improving overall hormone balance

Recovery: The early phase: the first few weeks
In the beginning, the focus is on stabilising the system.
Sleep is often the first area to improve, although for some people it may initially feel unsettled as the body begins to shift out of a constant stress state. It is not uncommon to feel more tired at this stage. This is the body finally allowing itself to rest.
You may notice:

• A stronger need for sleep or earlier bedtimes
• A reduction in the “wired but tired” feeling
• Slightly more stable energy through the afternoon
• A decrease in intense cravings, particularly for salt or sugar

Some people feel better quite quickly, while others feel temporarily worse before improving. This is often the nervous system beginning to unwind after being in a heightened state for a long time.

The rebuilding phase: months one to three
As the body begins to stabilise, more noticeable improvements tend to occur.  Morning energy often starts to improve, and waking becomes a little easier. The afternoon crashes may reduce in intensity, and energy levels begin to feel more predictable.
You may notice:

• Fewer energy dips during the day
• Improved concentration and clearer thinking
• A more stable mood, with less irritability or overwhelm
• Better resilience to everyday stress

Sleep tends to become deeper and more restorative during this phase, although it may still fluctuate.  At this stage, the body is beginning to rebuild rather than simply cope.

The restoration phase: months three to six
This is where deeper changes begin to take place.  Hormonal patterns start to regulate more consistently, and the body becomes more adaptable again. Many people find they can tolerate more without feeling completely drained afterwards.
You may notice:

• More consistent, steady energy across the day
• A return of motivation and drive
• Improved exercise tolerance
• Fewer infections and better immune resilience
• More emotional stability and a greater sense of calm

For women, menstrual cycles may begin to regulate. Libido may start to return. For men, energy and hormone-related symptoms often improve.  At this point, the body is no longer just surviving. It is actively recovering.

The deeper recovery phase: six months and beyond
Longer-term recovery involves restoring full resilience.  This is where the body regains the ability to handle stress without being thrown off balance. Energy feels more natural rather than forced. There is less reliance on stimulants, and recovery from physical or emotional stress becomes much quicker.
You may notice:

• A natural, sustained energy throughout the day
• Waking feeling refreshed without needing stimulants
• The ability to cope with stress without crashing afterwards
• Improved hormonal balance and overall vitality
• A stronger sense of wellbeing and emotional steadiness

At this stage, deeper markers such as DHEA levels, cortisol rhythms and overall hormonal balance are often much improved.

What to expect along the way
It is important to understand that recovery is rarely perfectly smooth.
Life will continue to happen. There will be busy periods, emotional stress, illness or disruptions to routine. During these times, symptoms may temporarily return.
The difference is that as recovery progresses, the body becomes more resilient. These dips tend to be shorter and less intense, and recovery is quicker.  Think of it as building capacity rather than chasing perfection.

A final note on patience
One of the biggest challenges in adrenal recovery is slowing down enough to allow it to happen.  Many people are used to pushing through, relying on willpower and stimulants to keep going. Recovery often requires doing the opposite. Very often, the body will cause an almight crash of some sort to sweep you off of your feet and force you to stop ploughing on during the worst stage.  
Recovery involves listening to the body, responding to its signals and allowing time for repair.  When supported properly, the body has an incredible ability to restore balance. The key is consistency, patience and creating the right conditions for that process to unfold.

If you want to test your adrenal health
Whilst symptoms can give us strong clues, testing allows us to see what is really happening beneath the surface.  There are a number of options available depending on how in-depth you would like to go.

Adrenal Stress Profile
This is one of the most direct ways to assess adrenal function.  
It is a saliva-based test that measures cortisol at several points throughout the day, allowing us to see your natural daily rhythm rather than relying on a single reading. It also includes DHEA, giving insight into how your body is balancing stress and recovery.
This is particularly useful if you are experiencing fatigue, poor sleep, or feeling wired at night but exhausted in the morning.
You can order the test here:
https://www.thriveclinic.uk/store/p106/adrenal-stress-profile.html

Neuro-Adrenal Panel
This test looks at both your adrenal hormones and your brain chemistry.  Alongside cortisol and DHEA, it assesses key neurotransmitters involved in mood, focus and motivation. This can be especially helpful if your symptoms include anxiety, low mood, brain fog, poor concentration or disrupted sleep.  
It gives a deeper understanding of how your stress response system and nervous system are working together.
You can find more details here:
https://www.thriveclinic.uk/store/p107/neuro-adrenal-panel.html

Whole Body Wellness Panel
This is a comprehensive blood test that looks at multiple systems in the body.
Although it is not purely focused on the adrenals, it provides valuable insight into the wider picture. It includes markers related to blood sugar balance, inflammation, thyroid function, nutrient status and overall metabolic health.  Adrenal dysfunction rarely exists on its own, so this type of testing can help identify underlying drivers that may be contributing to how you are feeling.
You can view the panel here:
https://www.thriveclinic.uk/store/p110/whole-body-wellness-panel.html

Hair Mineral Analysis (Heavy Metal and Mineral Test)
This test looks at mineral balance and potential toxic exposure over time using a hair sample.
It gives insight into certain ratios that reflect adrenal health and key minerals such as magnesium, sodium, potassium and zinc, all of which are essential for adrenal function. It can also highlight exposure to heavy metals such as aluminium, mercury and lead, which can place additional stress on the body.  This is particularly useful if recovery feels slow or if there may be underlying toxic or mineral imbalances affecting your energy and resilience.
You can order the test here:
https://www.thriveclinic.uk/store/p122/heavy-metal-toxicity-hair-mineral-test.html 

Ready to take the next step
If this resonates with you and you feel your adrenals may be struggling, you are very welcome to book a consultation with me.  We can go through your symptoms in detail, look at any existing results you may already have, and decide on the most appropriate testing and support plan for you.
You can find more information and get in touch here.