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Recharge your adrenals

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Overworked adrenal glands and insulin resistance are common causes of fatigue, weight gain and other symptoms in women, says hormone expert Marcelle Pick. Here’s how to spot the signs and reclaim your health

Kristen arrived in my office, like many women before her, almost completely worn down. She told me she simply had no energy to “do life.” She was eerily calm when she said this, her voice so full of weariness that my heart broke for her. Luckily, I knew what the problem was likely to be: adrenal fatigue, compounded by insulin resistance.

The two together can create a never-ending loop—high cortisol to insulin imbalance to high cortisol, around and around until a woman feels like total collapse is inevitable.

Here’s some good news: It’s not. There are effective natural solutions, and by taking small steps, you can make a big difference in your life.

What is adrenal fatigue?

Your adrenal glands are small but mighty. These little glands that sit on top of your kidneys produce a range of hormones, some of which you can’t live without.

The primary function of your adrenal glands is to help you respond to stress so you can survive. To do so, they pump out hormones like adrenaline and cortisol, which allow you to respond to stressful situations.

Cortisol helps convert food to energy, regulates blood pressure and cardiovascular functioning, reduces inflammation and manages your body’s immune response. It also activates the stress response that prompts you to fight, flee or freeze.

This is a crucial response in the face of real danger. The problem is your body perceives all stress equally, whether actual danger is present or not. And when it’s constantly responding to stress (which is ever-present in our modern lives), other important functions are put on hold.

Think about when you make a phone call and are put on hold. It’s typically fine for a few minutes, but when it goes on and on, the waiting can wear you down. It’s the same with your hormones.

Your body can wait a short time for them to come back into play, but if your adrenals are constantly producing cortisol instead of other hormones, imbalances occur—including insulin imbalances that can lead to big problems.

Adrenal fatigue is what many in the functional medicine world call the issues that result when your adrenals aren’t functioning properly. They may be producing too much cortisol or too little. Either way, a host of uncomfortable symptoms result, including fatigue, moodiness, sleep difficulties and weight gain.

Adrenal fatigue can also diminish your capacity to tolerate stress and lead to metabolic issues and frequent infection. And those are just a few of the symptoms that can occur.

Adrenal fatigue has many stages, and catching it early helps get your body back on track quickly. Unfortunately, conventional practitioners often refuse to acknowledge a problem until you’ve reached an extreme disease state. That’s where the controversy around the term adrenal fatigue comes from and why so many women are left to muddle through until they simply can’t anymore.

What is insulin resistance?

Simply put, insulin resistance is your body’s inability to properly respond to insulin. When this happens, you’ll feel fatigued, may experience more hunger or thirst, and (this is the symptom that brings most women to see me) gain weight and be unable to lose it, no matter what you try.

When your body can’t use carbohydrates efficiently, insulin resistance can develop. Typically, your body breaks the carbs you eat into glucose, which then enters your bloodstream. This increases blood sugar levels, and your pancreas secretes insulin to get this glucose to where it belongs: into your cells to be used or stored. When insulin guides glucose into the cells, your blood sugar levels normalize again.

If your body can’t listen properly to what insulin is telling it, your pancreas increases production—it’s kind of like shouting to get someone to hear you. If the cells still don’t listen and refuse to absorb the glucose, insulin levels remain too high for too long, increasing inflammation, disrupting metabolism and creating insulin resistance, meaning your cells just won’t respond at all.

Insulin resistance, also known as metabolic syndrome or syndrome X, is an early precursor to diabetes. It’s so widespread in our society today that it’s part of my standard protocol to evaluate women’s level of risk when they visit my practice.

Often, as with Kristen, I can spot the signs before I do any tests at all. While experts estimate that 24 percent of Americans suffer from insulin resistance, I believe that number is even greater among menopausal women.

That’s because hormonal balance is crucial to good health, and menopause is a time of natural fluctuations. But insulin resistance can happen anytime, even in women like Kristen who are nowhere near menopause.

Insulin is a hormone so vital to proper functioning that your body has a hard time balancing other hormones until the insulin resistance is dealt with.

Out of the loop

Hormones don’t act in isolation. They’re members of a large team that must work together, relying on each other to do their jobs properly to maintain balance. There’s a lot that can go wrong along the way, and when one hormone changes course, the others will too.

Cortisol produces fat and muscle cells that resist the actions of insulin as well as boosting production of glucose by the liver. This means that when circumstances are ideal, cortisol counterbalances insulin, helping to keep things steady.

When cortisol levels are high for too long, insulin resistance can develop. And high blood sugar levels that result from insulin resistance are perceived as stress in the body, prompting cortisol production and keeping levels elevated.

This is the loop I mentioned earlier, and if it isn’t broken, the problem lingers indefinitely. But there are many natural steps you can take to break that cycle.

Natural ways to heal

There’s no clear answer to the question “Which comes first, adrenal fatigue or insulin resistance?” Fortunately, the steps you can take to heal from each overlap nicely. Making changes to improve one will also help heal the other. Here are my top recommendations.

Eat for hormonal balance

To best support balanced hormones, including insulin and cortisol, you must pay close attention to what and when you are eating. The foods that are most convenient certainly aren’t the best choices.

Processed foods, fast food, and an abundance of sugar and carbohydrates can send your hormones on a downward spiral quickly. Think about a time when you’ve reached for a mid-afternoon candy bar to keep you going. How long did your energy last? Did you feel better or worse when the “sugar high” wore off?

Constantly changing blood sugar levels will place great strain on the adrenal glands. But you can keep things stable by choosing natural, whole, organic foods whenever possible.

Prepare healthy snacks ahead of time so you don’t give in to the lure of vending machines or fast food. Freeze batches of soup, prep vegetables for an easy stir fry or use a slow cooker to avoid ordering takeout at the end of a long day.

While I don’t advocate for one specific diet for everyone since we are all unique individuals, eating a keto diet can help reverse insulin resistance. The low-carb, high-fat nature of the eating plan puts your body into a state of ketosis, producing ketone bodies that can be used for energy. Evidence shows that ketosis can reduce the risk of diabetes as it reverses insulin resistance.

Changing your beverage choices can also make a big difference in the healing process. Avoid soda (even diet soda—sugar substitutes are worse than real sugar). Drink alcohol in strict moderation, if at all. Alcohol impacts insulin production and can cause your body to store glucose as fat, typically in the abdominal region.

Eat on a regular schedule to keep blood sugar levels stable. Keep carbohydrates under 15 g per meal and 7 g per snack, with a focus on fruit and vegetables rather than grains. Be sure your meals and snacks also contain protein. Include healthy fats in your diet to help combat insulin resistance, such as salmon or tuna, eggs, and avocado.

Support your body with supplements

Since it’s exceedingly difficult to get all the nutrients you need from food alone, high-quality supplements can be an important element for healing. When your adrenals aren’t functioning properly, targeted support can put you on the right path to good health.

These are the supplements I recommend when you are faced with adrenal issues and insulin resistance. But remember that every woman’s body is different, so it’s important that you work with a trusted professional to find the right combination for you.

Eleuthero helps to reduce stress, improve cognitive function, boost the immune system, increase energy levels and lower inflammation.

Suggested dosage:200–400 mg daily

American ginseng is an adaptogen used for thousands of years to help the body withstand mental and physical stress.

Suggested dosage: 50–100 mg daily

Ashwagandha is a relaxing adaptogen that reduces cortisol, improves brain function and combats anxiety.

Suggested dosage: 200–400 mg daily

Rhodiola is a powerful adaptogen known for its energy-boosting effects.

Suggested dosage: 200–400 mg daily

Noni is a tropical fruit that may reduce inflammation, boost immune function, improve endurance and support healthy energy levels.

Suggested dosage: 100–200 mg daily

Gotu kola is a powerful Ayurvedic herb that can help with increasing stress resilience, calming the nervous system and improving concentration.

Suggested dosage: 50–100 mg daily

B vitamins help to balance stress response and cortisol levels and to boost energy and mood. B5 is often called the “anti-stress vitamin” for its crucial role in producing stress hormones in the adrenal glands, and B10, also called para-aminobenzoic acid (PABA), helps regulate cortisol levels.

Suggested dosage: Amounts vary by vitamin; follow label instructions

Vitamin C is a key vitamin for adrenal function and health.

Suggested dosage: Up to 10,000 mg (10 g) daily

Bitter orange has traditionally been used to calm the nervous system and improve digestive function.

Suggested dosage: 250–500 mg daily

Inositol is a sugar made in the body and present in some foods that improves neurotransmitter function and the production of brain hormones.

Suggested dosage: 100–200 mg daily

Parsley fights inflammation and improves immune system function. It also contains apigenin, which reduces anxiety and modulates hormones.

Suggested dosage: Eat fresh or dried with meals or take 10–20 mg daily in a supplement

Rose hips support adrenal function and a healthy stress response.

Suggested dosage: 10–20 mg daily

Watercress is an antioxidant-rich aquatic plant that supports a healthy immune system.

Suggested dosage: Use as a vegetable in salads or cooked greens or take 10–20 mg daily as a supplement

Omega-3 fatty acids, especially EPA and DHA, have been linked to improved cognitive function, healthy blood lipid levels, positive mood and overall better health.

Suggested dosages: 700–1,500 mg EPA and 400–1,000 mg DHA daily

Phosphatidylserine is a rigorously studied phospholipid that improves stress resilience, cognitive function and memory.

Suggested dosage: 100­–600 mg daily, spread evenly throughout the day

A well-rounded multivitamin can also help your body, including your adrenal glands, function at its best. I’ve developed a multivitamin and several formulas that include the supplements above to assist you on your journey to better adrenal health (see Resources, below, for details).

Lead a healthy lifestyle

The way you live your life directly impacts the way you feel, especially when it comes to adrenal health and insulin resistance. Reducing stress is one of the most important things you can do to support your adrenals.

This looks different for everyone, but to be effective, stress reduction techniques need to be enjoyable. Forcing yourself to meditate or do yoga when they simply don’t work for you actually increases stress rather than alleviating it. Find a way to take at least a few minutes for yourself every single day. I find the quiet moments before my day begins are a great time to reflect and just breathe.

Exercise can be a critical factor in keeping insulin levels normal, balancing other hormones and regulating metabolic function. If your adrenals are strained, it’s best not to exercise too vigorously, so you can skip the spin class and take a brisk walk instead. If you are just getting started, try walking up and down stairs a few times a day or setting a timer for five minutes and marching in place. Any movement counts!

Don’t neglect to address emotional health. Emotional stress is just as hard on your body as physical stress, especially when you’ve been hanging on to it for years. Emotional distress can send you straight to “comfort foods,” which often come in the form of carbohydrates, leaving you more susceptible to insulin resistance as well.

Breaking the cycle

When you understand how your body responds to stress, you have the power to change the results. After Kristen began to shift what she was eating and found ways to reduce stress in her life, she came back to me radiant and ready to “do life” again.

Taking small steps toward a healthy diet and lifestyle can break the cycle of adrenal fatigue and insulin resistance, leaving you ready to enjoy life to its fullest.

Common symptoms of adrenal fatigue

  • Irregular blood pressure
  • Food cravings and abnormal weight changes
  • Spiraling energy
  • Unstable emotions and coping ability
  • Fuzzy thinking
  • Decreased immune response
  • Difficulty sleeping
  • Hormonal and libido fluctuations

Common symptoms and risk factors for insulin resistance

  • Family history of type 2 diabetes or personal history of gestational diabetes
  • Hypertension
  • Obesity
  • Weight gain around the abdomen
  • Dyslipidemia (especially low HDL levels and high triglycerides)
  • Skin changes called acanthosis nigricans, wart-like darkened patches of skin at the neck and in the armpits


Marcelle has developed her own range of supplements, available at These are the supplements she recommends specifically for adrenal problems and insulin resistance.

Adrenal Support Formula. This is a blend of vitamin B5, noni fruit extract and five adaptogenic herbs. Each ingredient has unique benefits for adrenal function, stress response, energy and immune function, says Marcelle.

Suggested dosage: One or two capsules with both breakfast and lunch daily

Adrenal Metabolism Support. This blend of vitamins, minerals and Ayurvedic herbs is great if you feel both wired and tired. It’s designed to promote calmness, reduce stress and naturally increase energy levels.

Suggested dosage: One or two capsules with both breakfast and lunch daily

Multi Essentials +. This multivitamin and mineral supplement features 19 important nutrients as well as Albion chelated minerals to promote maximum absorption and bioavailability.

Suggested dosage: One or two capsules daily with food

EPA/DHA Support. This omega-3 supplement is sourced from cold-water Alaskan fish. Each softgel provides 720 mg of EPA and 480 mg of DHA.

Suggested dosage: One or two capsules daily with food

Stress Ease. Ideal if you’re having trouble getting to sleep at night, it provides 200 mg of phosphatidylserine, which helps maintain optimal function of the nervous system, says Marcelle.

Suggested dosage: One or two softgels before bed


Marcelle Pick, ob-gyn nurse practitioner, is passionate about transforming the way women experience healthcare through an integrative approach. She cofounded the world-renowned Women to Women Clinic in 1983 with the vision not only to treat illness but also to support her patients in proactively making healthier choices to prevent disease. She has successfully treated thousands of individuals through her unique approach to wellness.

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