Adrenal Fatigue and Exercise

By: Michael Lam, MD, MPH; Dorine Lam, RDN, MS, MPH

Most people think of exercise as jogging or muscle building. While these are beneficial to general good health and promotes circulation and muscle strength, it is not the best solution when it comes to Adrenal Fatigue. In fact, wrong exercises may make Adrenal Fatigue worse and can trigger adrenal crashes easily.

Let us examine this deeper. The common misconception is that Adrenal Fatigue equates to low energy. A state of low energy can be the cause of the body's inability to overcome stress whether it is physical, mental, or emotional. Because all functions of the body require energy, the most prominent outcome in those with Adrenal Fatigue is low energy.

At the root level, however, it is much more complicated. The loss of energy is due to the uncontrolled state of the body. Think of a car that is running low on gas, has a steering wheel problem, a sticky gas pedal that continues to accelerate at will, and a brake pedal that malfunctions intermittently. In other words, many of the systems that ensure a smoothly running vehicle are broken. The car is no longer under control, and unable to get you where you want to go. It is also a sure recipe for an accident. If you can correspond that to your body, then you are not far away from Adrenal Fatigue.

Our body, like a car, needs to run smoothly for us to feel well. This involves perfect synchronization of numerous organs and systems. In Adrenal Fatigue, the body is drained and low on energy, like a car running low on gas. Concurrently there are numerous imbalances. Many hormones are dysregulated, and as a result, in addition to having low energy, the body suffers from hypoglycemia (too little gasoline in the gas tank), feelings of being "wired" (sticky gas pedal that stays down), foggy thinking (driver who texts while driving), and depression (brake pedal is burned out). The internal thermostat of the body is broken and it is no wonder that the adrenals crash with each little stressor.

Overall Exercise Strategy

The key to a successful Adrenal Recovery Exercise Program involves a well thought-out strategy that helps you regain control of the core functions of the body. In the analogy of the car, it is not only about putting more gasoline in the tank. You can have fuel in the car and still be unable to get to where you want to go if the steering system is not functioning. The goal is a complete rebalancing of the internal systems, so that they can operate smoothly together to get you where you want to go hassle-free. This involves a total mind-body approach incorporating lifestyle, diet, mental, nutritional, and physical components. Exercise is an important part of the total recovery plan. If done properly, it helps the adrenals boost their function, and thus the energy state.

Energy State and Exercise

Those in early Adrenal Fatigue (Stages 1 and 2) may only feel tired intermittently and tend to recover from any low energy state quickly, Those in advanced Adrenal Fatigue (Stage 3 and 4) are characterized by a constant low energy state and fatigue, only to worsen over time. Because the total energy in the body is finite, it is important to custom tailor an exercise program for the best use of limited energy resource for those with advance weakness. Over utilization of energy for exercise, even if it is good for circulation and has other health benefits, may trigger adrenal crashes. The right intensity, amount, and frequency is paramount. Many are drained of energy after exercise. The tendency is to avoid it. Total absence is also undesirable except during an adrenal crash. Others would do the opposite, forcing themselves to do more, and thinking that it is beneficial. Both approaches can be wrong. The key is not to avoid exercise totally, but to have a personalized program designed specifically for the level of adrenal function.

It is important to provide and have a consistent and maintained energy stream for vital organs to overcome low energy state. Any excess energy can be channeled into exercise as a healing tool. The amount of exercise must be adjusted to avoid over-stimulation of the sympathetic nervous system and trigger adrenaline release. Risk of adrenal crash must be carefully monitored and preventive steps must be taken at the right time consistently. The right thing done at the right time will be of tremendous benefit. Conversely, the right thing done at the wrong time will make things worse.

Experienced clinicians will want to conserve energy as much as possible during the initial healing process. This means exercises that do not reduce energy but increase energy flow in the body. After a comfortable level of reserve is accomplished and built up in the body, a gradual progression is effected so that the body can reverse its catabolic state into an anabolic state where muscles start to rebuild and strengthen. This has to be done on a step-wise fashion deliberately and gradually. Doing this might help avoid one of the most common recovery errors among those self-navigating as well as inexperienced clinicians - over zealous exercise leading to retarded adrenal recovery.

A properly designed Adrenal Recovery Exercise Program needs to factor in the following technical components as well: breathing, muscle toning, stretching, strength training, motion fluidity, control, and systemic circulation. It needs to take into consideration the state of adrenal function (Stage of Adrenal Fatigue), the amount of reserve remaining, the biological constitution, age, metabolic issues, past medical history, and injuries.

As with any exercise program, always consult and seek approval of your personal treating physician prior to beginning.

Exercise Tool Box

The toolbox to affect this consists of six important tools. Each has its place and has to be deployed at the right time for maximum benefit. Improper use of exercise, whether it be too much, too little, or wrong timing can make Adrenal Fatigue worse, and trigger adrenal crashes, especially if the body's reserve is low. The proper program allows the body a total healing experience, starting at the cellular level in the core of the body.

The body has an internal repair system in place. Our job is to systematically give the body the tools to affect that repair. Fortunately, our body is forgiving. The proper adrenal exercise can help the body return to its normal state of function.

The six tools are:

  • Beginner- focus on breathing and stretching
  • Intermediate- focus on toning and strengthening
  • Advance- focus on fluidity and control
    • Regular Yoga
    • Power Yoga
    • Aerobics

Here is a graph that shows how following a comprehensive exercise program in stages can help restore the adrenal function and energy:

How to progressively incerease your exercise regimen while recovering from Adrenal Fatigue

Adrenal Breathing Exercise

Because breathing is an automatic function, few take the time to understand its therapeutic significance in the Western Medical world. Most of us are not taught the significance of proper breathing and its healing power. As a result, the vast majority of people simply do not breathee properly while in a normal healthy state, not to mention any state of body weakness such as Adrenal Fatigue.

Three main sets of muscles are active when you breathee normally: the intercostal muscles, the abdominal muscles, and the respiratory diaphragm. All muscular activity of the body, whether it be contraction of individual cells, isotonic or isometric exercise, agonist or antagonist activity, concentric shortening, or eccentric lengthening, take place strictly under the guidance of the nervous system. breathing is special in that it involves both the Somatic Nervous System and the Autonomic Nervous System (ANS). In other words, you can voluntarily control breathing, or if you choose not to do so, the body will take over automatically. Both systems are therefore connected. The ANS is self-regulating and is not usually controlled by the Somatic Nervous System. For example, you cannot voluntarily decide to make the heart rate beat faster or slower. This is normally regulated by ANS and is beyond the Somatic Nervous System control. However, you can influence the heart rate by regulating, on a conscious level, the respiratory rate because breathing connects both nervous systems. Long exhalation will slow down heart rate during the exhalation process. By modulating our respiratory rate at will, we can influence the ANS. breathing therefore offers an important gateway into the world of the ANS, allowing us to modulate it. This is of vital importance to those with advanced Adrenal Fatigue when the Autonomic Nervous System is invariably dysfunctional.

The ANS is broadly divided into the Sympathetic Nervous System (SNS), which is responsible for adrenaline release and the fight or flight response on one side, and the Parasympathetic Nervous System (PNS), which is responsible for rest and relaxation of the body's internal function. In quiet times when there is less need for air, the PNS mildly constricts the smooth muscle that surrounds the airways, especially the smaller bronchioles, and thereby impedes the flow of air to and from the alveoli. But in times of emergency or increased physical activity, the SNS opens the airways and allows air to flow more easily. The PNS, by way of release of its neurotransmitter, acetylcholine, works in a dynamic balance with the SNS, by releasing its neurotransmitter, norepinephrine, to modulate and maintain homeostasis in our body. This delicate balance must be maintained for us to feel good.

Adrenal Fatigue, especially in the advanced state, is invariably tied to overstimulation of the SNS. Extensive experiments have shown that Type A high strung personalities have about threefold more plasma norepinephrine responses and fourfold larger adrenaline responses during exposure to various laboratory and clinical stressors than compared to Type B individuals who are laid back and relaxed. These chemical transmitters of the SNS flood the body in Type A individuals, resulting in a body that is on constant alert, leading to a viscous downward spiral of compensatory responses and ultimately adrenal burnout. One key to adrenal recovery is to reduce SNS tone and enhance PNS tone. Adrenal breathing can help greatly. Adrenal breathing influences the autonomic circuits that slow the heartbeat and reduce blood pressure, producing calm feelings and a sense of stability. It calms the mind, and allows the body's internal homeostatic system to reset itself. This conduit by way of controlled respiration consciously gives us access to autonomic function that no other system of the body can boast.

Those with severe adrenal weakness often exhibit abnormal breathing patterns. Abnormal breathing patterns in an Adrenal Fatigue setting can over-stimulate the SNS, trigger panic attacks, and contribute to adrenal crashes. We tend to breathe shallowly or even hold our breathe when we feel anxious or are under stress. Sometimes we are not even aware of it. Shallow breathing limits oxygen intake and adds further stress to the body, creating a vicious cycle. Holding one's breathe either at the end of inhalation or exhalation stimulates the sympathetic nervous system, aggravating adrenal weakness if the body is already in a state of low adrenal reserve. Adrenal breathing Exercises can break this negative cycle by rebalancing the ANS and gently delivering more oxygen to the body for natural energy generation without over-stimulating the SNS. The body gets to take a break and reset itself to its natural state.

Proper adrenal breathing releases tension from the body, clears the mind, reconnects the body to the mind, reduces fatigue, and improves both physical and mental wellness. This is accomplished through enhancing the Parasympathetic Nervous System's function. It shifts the body's basal resting mode from a sympathetic to a parasympathetic bias.

Bear in mind that in Eastern cultures, breathing is also used as an effective modality to enhance energy and alertness by stimulating the body's Sympathetic Nervous System (SNS). This is seen frequently in certain types of yoga breathing and is usually accomplished by various techniques involving breathe holding that gradually increases intensity and performing quick breathing exercises with high frequency (belly breathing). Another technique involves using the chest wall only to affect breathing and this is called thoracic or paradoxical breathing. The chest wall expands while the abdominal wall is drawn inward towards the back during inhalation and outward during exhalation. While these breathing techniques are empowering and increase energy flow, they can also drain the body of the already low energy state of Adrenal Fatigue. They therefore should be avoided in Adrenal Fatigue.

In adrenal breathing, the goal is to reduce sympathetic tone. All sympathetically driven and oriented breathing techniques should therefore be restricted and not be deployed until the adrenals are well healed or unless directed by your health care professional. breathing programs that do not consider this may make Adrenal Fatigue worse.

Proper adrenal breathing patterns should be smooth, quiet, regular, and rhythmic. Intensity of each breathe must match the body's current state of reserve. There should be no intentional breathe holding or prolonging of breathing time during inhalation or exhalation. This is best accomplished by gentle breathing using the diaphragm. This is often referred to as abdominal breathing, or belly breathing, because this is where movement can be seen and felt. Improper technique can worsen Adrenal Fatigue.

Beginning students and those with advanced Adrenal Fatigue (Stage 3 or higher) and weak constitutions should be very careful in the inhalation and exhalation intensity. Forcing more air in and out of the lungs beyond what the body can tolerate may drain the body of reserve and potentially have a negative effect of activating the SNS. This can trigger adrenal crash. The intensity level may need to be titrated downwards significantly in times of adrenal crashes.

If properly done, Adrenal breathing Exercise using the diaphragm helps to restore adrenal health by enhancing parasympathetic tone, improving lymphatic circulation and clearing up toxic metabolites. The activity also improves vital capacity, supports healthy ANS balance, improves tissue oxygen saturation, and effects gentle rhythmic massage on the GI track and internal organs including the adrenals, and optimizes musculo-skeletal tone. It is one of the easiest and most effective exercises anyone with Adrenal Fatigue can do at anytime and anyplace to support adrenal recovery.

Adrenal breathing Exercise takes as little as a few minutes to complete and can be done anywhere at anytime. No equipment is necessary. The exact program varies from person to person. The frequency and intensity depends highly on the stage of Adrenal Fatigue. Because the wrong inhale and exhale intensity can trigger an adrenal crash, this exercise should be done under professional guidance.

Adrenal Restorative Exercise

Dysfunction of the body's ability to handle stress affects not only the adrenal glands, but also the Central and Peripheral Nervous Systems. Almost all advanced Adrenal Fatigue patients have significant dysfunctional Autonomic Nervous Systems (ANS). A complete Adrenal Fatigue recovery program must therefore incorporate modalities designed to restore nervous system health and balance.

Adrenal Restorative Exercise is a set of specially designed exercises to promote deep and active relaxation. Utilizing established restorative yoga poses and adapting to enhance adrenal function, it focuses on a key aspect of Adrenal Fatigue--repairing the mind-body connection and restoring nervous system homeostasis.

Adrenal Restorative Exercise is not like regular exercise, where you focus on stretching and strengthening. For those in Adrenal Fatigue, this approach will leave you feeling physically strained and exhausted. In some, this will trigger an adrenal crash. Adrenal Restorative Exercise is different! This approach is specifically designed to help people with Adrenal Fatigue; for whom even gentle stretching is too active and for those who need to restore their health and find balance again in their lives. People who have had injuries, surgery or prolonged physical conditions such as high blood pressure will also find Adrenal Restorative Exercise a breakthrough experience. It it is a special form of therapeutic exercise with a focus on healing.

Adrenal Restorative Exercise focuses on being, connecting the mind and body, allowing signals from the mind and body to reconnect in a restorative and nurturing mode. The Autonomic Nervous System responds to such modulation well. These exercises rely on a customized sequence of specially designed postures in which your body is comfortably supported. This allows your joints to be open, and muscles to utterly relax and melt into place instead of stretching and straining into position. Blood flow to the adrenals is increased, and the nervous system switches to calmness and a deep inner mode of healing.

The Essence of Adrenal Restorative Exercise:

  • Promote activation of the Parasympathetic Nervous System (PNS) without over stimulation of the Sympathetic Nervous System (SNS).
  • Promote joint mobility and range of motion to overcome immobility common in Adrenal Fatigue.
  • Improve posture and biomechanics of the body function.
  • Allow muscles to relax without worsening the catabolic state.
  • Enhance blood flow to the adrenal glands to support recovery.

Key sequences include:

  • Neck Restorative Sequence. The neck represents the anatomical area of the body that is critical in the overall nervous system, because this is where the major nerves and arteries branch off. Your neck muscles and your posture control the spine and set the muscular tone for the rest of your body to follow. You cannot have a relaxed body if your neck is tense. Conversely, the body cannot help but relax once the neck muscles are rested.

  • Spine Restorative Sequence. This is designed to open up the spine and realign the body posture properly. This is important because all key muscles in the body are connected to the spine directly or indirectly. Proper spinal alignment controls the muscles and therefore the vessels and nerves that run through it.

  • Circulation Restorative Sequence. This is designed to restore circulation within the body to its maximum flow and remove any strain or tissue that may be interfering with this process. We accomplish this by opening the two key outlets where circulation flows--the Thoracic Outlet and the Femoral Outlet.

  • Mind-Body Restoration Sequence. This final and most important sequence of poses is designed to connect the mind and body. All previous poses are designed to prepare the body for this mind-body reconnection. Blood flow to the adrenals is increased, and the nervous system switches to calmness and a deep inner healing mode.

The complete program consists of twelve sequential positions or poses. The entire session takes about fifteen minutes and can be as long as one hour simply by extending the amount of time spent in each position. Beginners may start with as little as twenty seconds per pose and slowly scale up.

Adrenal Restorative Exercise is particularly good for advanced Adrenal Fatigue. However, it can trigger an adrenal crash if the body is not ready. This is especially common in those with advanced adrenal weakness and in a severe catabolic state. Proceed only under professional guidance.

Adrenal Yoga

Yoga is not a religion. Although it came out of ancient India, it is not a form of Hinduism. Modern yoga dates back to 1893. Christians, Buddhists, Jews, Muslims, and Atheists alike happily practice yoga. There is certainly a spiritual side to yoga, but you do not have to subscribe to any particular belief to benefit. Yoga is a systematic technology to improve the body, understand the mind, and free the spirit. Practitioners tend to be more flexible, stronger, more energetic, thinner, and more youthful--all of which are desirable in Adrenal Fatigue recovery.

With practice, you are strengthening and calming the nervous system. It balances the dysfunctional stress-response system suffered by most in Adrenal Fatigue. Blood flow to internal organs is increased; more oxygen is delivered to the adrenal glands for healing; mental clutter is cleared. Spiritual as well as physical muscles are cultivated to make you happier, less anxious, and more at peace.

Because yoga builds on itself, it becomes more effective over time. It is equivalent to learning how to play a musical instrument: the longer you stick with it and practice the better you become and the more you get out of it.

Adrenal Yoga takes the best of traditional yoga and modifies it to suit those with Adrenal Fatigue. For example, certain stretching and strengthening exercises known as asana are removed, because they can stimulate the SNS. Gone are certain breathing techniques known as pranayama that can trigger a release of adrenaline. Posture and lung capacity are improved as is bowel function, lymphatic draining, and the function of the immune system. Gradually one feels more balanced and the body is better able to endure stress of daily living. Adrenal Yoga then, is about restoring internal balance, and with balance, internal control. It is not about physical flexibility, as many with Adrenal Fatigue are already quite flexible. It is not about increasing strength, as many men are strong and still suffer from Adrenal Fatigue. Adrenal Yoga is able to transform liabilities such as fear, inability to relax, low energy, anxiety, and depression into strength, giving the person exercising more control and a more balanced feeling.

Adrenal Yoga is a special form of therapeutic yoga that is gently nurturing by design. It places heavy emphasis on body awareness; rhythmic adrenal breathing that is non stimulatory, proper postural alignment, and movements that tone muscles. Special attention is placed on slow and relaxed motions that are suitable for all, including those that are in advanced adrenal failure and possibly close to being bedridden.

Science now realizes that changing dysfunctional habits is largely a matter of the mind. Adrenal Yoga helps by giving you greater control of your mind as well as greater understanding of the tricks it can play. This, perhaps, is what leads to a life transformation. This is particularly important in Adrenal Fatigue, when emotional stressors are the major cause of dysfunction.

Those with advanced adrenal weakness will especially appreciate Adrenal Yoga and its transformational power. Adrenal Yoga focuses on enhancing and restoring parasympathetic nervous function by teaching the mind to work against the opinion. By slowing down the fluctuations of the mind, you can get in touch with a more blissful place inside. With practice, you will become more aware of a calmness at your core throughout the course of the day. It helps you to realize that much of what you routinely get upset and anxious about is not that important. It's almost like toning down the repetitive obsession we have subconsciously about past resentments, old glories, and worries about the future. It puts our fear, desire or hate in a balanced perspective that can be dealt with in a systematic and logical manner. It forces us to stay with the present.

It lowers breathing and heart rate, increases blood flow to internal organs such as the adrenals, intestines and reproductive organs, and allows you to rest and digest. Many Adrenal Fatigue sufferers have concurrent gastric and assimilation difficulties. Adrenal Yoga enhances the relaxation response and avoids active stimulation of the SNS from exercises like backbends and strong pranayama technique. It lowers the level of cortisol when high, and modulates blood sugar levels. It does not quarrel with science but supplements science. Adrenal Yoga therefore complements modern medicine's strength by providing more options for people in need of healing.

Adrenal Yoga is holistic emphasis on strengthening your body and mind. It helps you get the most out of whatever other care you receive-alternative or conventional therapy for your Adrenal Fatigue.

The Adrenal Yoga exercise series is therefore, comprehensive and unique. The entire series is broken down into twenty-one sequential sessions that are grouped into three modules. Each module embraces specific themes customized to gently and effortlessly nurture the adrenals back to health. These themes are laid out in different sessions lasting anywhere from thirty-to-sixty minutes each. Each session in turn consists of a well-designed sequence of gentle postures that collectively offer a profound healing effect. The key to success is to start slow and progress through the sessions gradually and consistently, using the adrenal breathing technique throughout.

Let us examine each of these modules in more detail:

  1. Beginning Adrenal Yoga focuses on breathing and stretching. This forms the foundation of internal control.
  2. Intermediate Adrenal Yoga focuses on strength and toning. This serves to reverse the catabolic state and stabilize metabolic function.
  3. Advanced Adrenal Yoga focuses on fluidity and control. This serves to fine tune internal body homeostasis.

Many have gone from being almost bedridden to an active lifestyle with the help of Adrenal Yoga. The entire series can be achieved in three to six months.

When you are done with the Adrenal Yoga series, the body is fit and toned. The internal tune-up has been accomplished, muscular definition returns. The core body function is optimized. It comes as no surprise that people report a great increase in energy, reduction in fatigue, better blood sugar balance, stable blood pressure, increased sense of calmness and reduced anxiety.

Upon completion of the Adrenal Yoga series, you should be able to go into any regular gym and participate easily with any yoga or power yoga program at the beginner/intermediate levels without feeling drained or tired. For many of you who are in severe fatigue, this may sound impossible. Well, you will see for yourself. The key to success is to follow the lessons, be consistent, be patient, and let the body come to you. Our body has miraculous internal healing powers. Giving it the proper tools is all it takes to get started.

As with Adrenal Breathing and Restorative Exercise, there is a potential of adrenal crash if it is not properly accomplished. For best results, Adrenal Yoga should be conducted with professional guidance.

Gym Yoga and Power Yoga

When you are ready to do yoga in a commercial gymnasium or want to follow a DVD at home, make sure to remember that you are still building your reserves. Since each program is different, suffice to say that you want a higher level of yoga that goes beyond what you have been able to accomplish with Adrenal Yoga. The tendency is to be overly aggressive, and that is not appropriate. Overly aggressive exercise, even with yoga, can trigger adrenal crash. These tips may be particularly helpful to avoid any backlash or injury:

  • In your poses, find an edge for yourself where you are challenged but not overwhelmed. At this edge, practice maintaining a clear, open, and accepting mental state.

  • Give yourself permission to rest when you feel overworked.

  • Pay close attention to what you are saying to yourself as you practice, and make an intentional effort to appreciate your own efforts and innate goodness.

  • Go to class faithfully, arrive early, and talk to a few people in your class before class begins.

  • Realize that the development of qualities like patience, discipline, wisdom, right effort, kindness, gratitude, and many others will arise from your yoga practice. These qualities create a steady and soft mind.

  • Find a teacher who offers a balance of gentleness and firmness and whose teaching inspires you to practice from your highest self.

  • Recognize that simply attending class is a major statement of courage, self-care, and positive momentum. Realize that you are inspiring others as you become truer to your deepest desires.

The next level of inner core training is power yoga. It is a general term used in the West to describe a vigorous, fitness-based approach to yoga. Most power yoga's are closely modeled on the Ashtanga style of practice. The term power yoga came into common usage in the mid 1990s, when several yoga teachers were looking for a way to make Ashtanga yoga more accessible to Western students. Unlike Ashtanga, power yoga does not follow a set series of poses. Therefore, power yoga classes can vary widely from one to the next. What they do have in common is an emphasis on strength and flexibility. The advent of power yoga heralded yoga's current popularity, as people began to see yoga as a way to work out. Power yoga brought yoga into the gyms of America.

Power yoga classes can vary widely from teacher to teacher. However, power yoga will most likely appeal to people who are already quite fit, and who enjoy exercising. With consistent practice, muscle definition becomes prominent, toning is enhanced, and strength is improved. Power yoga represents an advanced form of yoga that focuses on the core strength.


We have two systems of energy production in our bodies-aerobic and anaerobic. Anaerobic exercises include activities that require fast explosive movements such as weight lifting, fast paced jogging, and any other exercise that cannot be performed for a long duration of time. This type of exercise is good for the heart, but it tends to put excess stress on the adrenals. They can trigger adrenal crashes if the adrenals are already low in reserves and weak. Those with advanced Adrenal Fatigue (Stages 3 and 4) should be particularly careful. They should be under professional guidance for Adrenal Fatigue.

Aerobic exercise includes long duration and slow paced activities such as walking, slow jogging, slow cycling, and any other form of exercise that involves endurance. This type of exercise will help decrease cortisol levels and aid in burning body fat as well. Aerobic exercise will benefit those who have stressed adrenal glands in the early stages, where cortisol output is high.

Intense aerobic exercise, however, can also worsen adrenal function. Those with advanced adrenal weakness should not consider any activities more strenuous than walking or as instructed by their health care provider. Excessive aerobic activities drain the body of already low energy reserves.

Those in advanced Adrenal Fatigue should avoid all aerobic activities other than walking. Frequency and duration varies from person to person. Some may be able to tolerate only five minutes of walking every other day.

Aerobic exercise is generally introduced carefully and slowly at Stage 3b. As Adrenal Fatigue improves, frequency and intensity can be increased.

Here is a table summarizing when to emphasis each program:

Table showing the Adrenal Fatigue exercises


© 2005  Michael Lam, M.D. All Rights Reserved.

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