Adrenal Fatigue and Exercise – Part 1

By: Michael Lam, MD, MPH

You have to do the correct Exercise when suffering from Adrenal Fatigue

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.

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Energy State and Exercise

Exercise can make you tired with Adrenal FatigueThose 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.

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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:

Exercises for each stage of Adrenal Fatigue

Read Part 2 | Part 3

© Copyright 2012 Michael Lam, M.D. All Rights Reserved.

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  • kevin says:

    Hi Dr Lam,

    I am a 30 year old male and wish to be able to lift heavy,get in shape and feel good but unfortunately i seem unable to do so…

    when i was around 20 i was diagnosed with prolactinoma a large one. and put on hydrocortisone and dostinex to treat the tumour and help with out of whack hormones including low cortisol.

    10 years later i am now off the hydrocortisone as they feel my body is producging okay on its own… and just taking dostinex.

    problem is when i workout lift/jog etc……

    i get a lot of problems the longer i continue to do it.

    erectile dysfunction
    feel on edge/jittery
    cold/flu like symptoms.
    extreme hunger

    now if i take a few weeks off working out and rest/eat well i get back to feeling healthy and sleeping well…
    but i get out of shape and depressed from lack of activity.

    so i have two choices…..

    workout and look aesthetically better but feel like ^&%*, no erections, and lack of sleep

    dont workout…. become very overweight but feel better, get good sleeps.

    it seems that just one or two workout sessions is enough to send my body into some sort of crazy low immune, unwell state where nothing works properly and i crave food like a black hole that never fills… and i find i cant sleep and tbh dont feel it….. i have had 6 hours max in the last 3 days since returning to the gym….. and feel wide awake despite my body feeling tired.

    • Dr.Lam says:

      Your body’s nutritional reserve and resilience may be low and thus easily drained when energy output to exercise dragg you down. When that happens, the body will force a slow down. You need to find the balance between normal living and workout, and also the type of workout is also very important. Avoid intense pulsitile internval type peak performance training which can be very stressful for the body.

      • kevin says:

        i just find any exercise in general to be bad for me.. even slow steady state cardio… when performed 3-4 times a week can lead to me being unable to achieve an erection until i stop completely and within a week things come back to normal…. as long as i dont excercise and eat fatty foods like pizza etc….

        when i eat healthy and excercise i become insomniac, weak ( despite getting stronger) and cant achieve erections…

        i thought maybe it was still related to cortisol ? or im depleting my body of something when i workout ? salt etc..

        basically when i excercise long term i become ill… so it seems to me.

        thanks for replying so fast!!

  • Neelam Kumari says:

    Hello Dr.Lam

    I loved you all articles.

    i have problem with my weight.My age is 25 and weight is 58Kg. my height is 4 and half feet. whenever i try to do diet and exercise. it does not work for me, my thyroid is also normal.
    What should i do. My blood group is A+.

    What should i do Doctor. Please Help me,


    • Dr.Lam says:

      Everyone’s metabolism is different. Maybe for your body, that weight is equilibrium point. The only way to force loose weight is to reduce calorie intake or increase metabolism. you can do both provided that you dont hurt your body in the process. Sliming pills, for example, can increase metabolism if you do high dose, but it can be bad for your body. The blood group diet works many but not all. you can follow,but do depend on it.

  • Shelly says:

    I was an emergency worker/mother of two for many years, I’ve had a few mishaps, neck injury and burn out, I seem to be getting worse every week, it’s been almost 3 years now, I sleep 3-4 hours, 30-40min at a time, gained 20lbs I can’t lose no matter what I do!!
    So tired I can barely even move:(

    • Dr.Lam says:

      You should see your doctor first to make sure you do not have medical issues such as anemia or low thyroid function that can present as fatigue. If you have exhausted conventional workup, then start educating yourself with AFS. Read my book is the best start as it gives you the science behind what is going on in simply language. Click Book – Adrenal Fatigue Syndrome – Reclaim Your Energy and Vitality with Clinically Proven Natural Programs for more information. Exercise should be reduced to match the body’s energy state. Click Adrenal Fatigue & Exercise for more information. If you are in early stages of AFS, self navigation can be considered. If you are in advanced stages, get someone to help you who knows what they are doing. We do have telephone coaching program that can be considered as well, but because it has limitations on who can join, you need to qualify first.

      Dr Lam

  • Cadie says:

    I have PCOS and I know that I need to lose weight but it seems impossible. Could this be because of Adrenal Fatigue?

    • Dr.Lam says:

      PCOS is associate with insulin and metabolic imbalance. It can be present concurrently with AFS. Both AFS and PCOS can be associated with difficulty in weight loss.

      Dr Lam

  • Pam Carter says:

    I have been competing competitively in triathlons and marathons for many years. I have come to a complete halt and have been dx with adrenal fatigue. Can’t give up at least trying to do some form of swimming, biking or running although it is at a snails pace. 56 years old and on hormone replacement. What else can I do to overcome this and return to competition?

    • Dr.Lam says:

      you should focus on getting your adrenals supported and optimized. at the interim, some exercise should be considered as long as the body can tolerate. it is rather complex because for return to peak performance, one has to have a detailed and comprehensive program that helps the body exercise capacity without overstraining the adrenals, and the kind and intensity need to match the body’s recovery at every point to avoid relapses and crashes. I have devoted an entire chapter on the proper approach in my book which would be a good read for you. Click Book – Adrenal Fatigue Syndrome – Reclaim Your Energy and Vitality with Clinically Proven Natural Programs for more information. I am not a fan of hormone replacement though it has its place in very small number of people because of various long term negative effects so do be careful.

      Dr Lam

  • Sonette Joubert says:

    Good day. After a hair analist I was diagnosed with adrenal burn out. I struggle to lose weight. Everytime I start exercising, I gain weight and can’t seemed to lose it again. What exercises can I do to lose weight? I am a woman and am 46.

    • Dr.Lam says:

      Weight loss is almost impossible when you have AFS ( unless you are in catabolic state) because the body wants to hang onto fat to generate hormone and energy. AT the right time, it will come off. You need to do the right thing at the right time. Excessive exercise can actually trigger adrenal crash so you have to be careful. Click Weight Loss & Adrenal Fatigue for more information.

      Dr Lam

  • Ruby says:

    Hi Dr. Lam, I work out everyday but have started to really get tired after 15 or 20 minutes. My mother was just recently involved in an accident, and though she’s okay, it was touch and go for a while there. Am I on my way towards a crash?

    • Dr.Lam says:

      If you feel tired anytime for 6 continuous hours after exercise ended, that may be a sign that you need to rest more. The problem with exercise is that many often feel better during the exercise itself and that is driven by the hormone epineprhine. Its only after you stop the exercise that the epinephrine spike start dissipating that you feel the slump and that is a negative sign, so do pay attention. you should feel good during and after exercise with no slumps.

      Dr Lam

  • Rania says:

    I am 47 years of age (female) and involved in martial arts training (hapkido). Both last year and this year, during the winter months I have experienced frequent colds and as soon as I get better I stay well for a short period of time and then I catch a cold once again. I’ve noticed over the past couple of weeks that when even thinking about my workouts and getting ready to leave the house I feel “down” even though I enjoy martial arts. It’s as though I am forcing myself and if I don’t end up going to my usual training I feel guilty about having missed a lesson. I’ve also noticed that my recovery period from aches and pains has also increased. What would you advise me on this?

    • Dr.Lam says:

      You need to learn to listen to your body. While exercise is good, the intensity and frequency may be too much and you need to get started slowly after inactivity for some time. YOu cannot drain your body too much unless you are ready. If you have AF, you have to start slow. My adrenal yoga series can be considered to help you built up if you have been weak. otherwise, start walking slowly and get yourself stronger over time . Click DVD – Adrenal Yoga Exercise – Volumes 1 – 4 for more information.

      Dr Lam

  • G from Toronto says:

    I started having sleep problems after switching my daily exercise routine from HIIT or “burst” exercises to just walking. I would sleep like a baby before although I still have AF symptoms like feeling fatigued. Now, I would wake up in the middle of the night now from 2 to 3 hours. Before, that would only happen when I am close to my monthly period. Please let me know why is this happening. Can you also please refer an AF naturopath here in Toronto, Canada. Thank you.

    • Dr.Lam says:

      When your body is used to being stimulated, adrenaline release is constant and when you go to a more gentle exercise, its release continues. That means there may be underling issues that is preventing the auto regulation to take place. We deal with this problem a lot. I dont know of any one in your area that is expert in this.

      Dr Lam

  • Troy says:

    I developed myoclonic jerks last year that were severe, due to stress, caffeine and over exercising through adrenal disfunction in which I took three months off work. I am a non smoker, non drinker eat nutritionally and take adrenal supplements (adrenoplex). Gradually the Jerks have subsided after completely stopping exercise (other than walking) to now walking hikes without much issues. However more moderate to intense exercise (like swimming/surfing) produces elevated adrenaline that cause at best, insomnia and severe jerks for around two nights after. I assume dopamine is being used up in response to the physical stress relative to increased acetylcholine causing excitory responses. I take natural gaba from teas (passsionflower), tinctures, foods and b vitamins etc but non of those make any difference as compared to days of light – moderate exercise where these protocols work well. Should I be inhibiting gaba to produce more dopamine? I wish to be able to swim and surf again (moderate – intense exercise). it’s been one year since the problems started. Is there anything else I can do? Does adrenal disfunction sometimes take years to balance these stress hormones? Missing the water! Thankyou.

    • Dr.Lam says:

      The body self balances and inhibiting gaba etc to try to shift to more dopamine can actually make things worse. the real issue is really about balancing the amount of adrenaline you need to live an active life and not overly stimulating your body. supporting the adrenals with non stimulating compounds should be considered and as the adrenals get supported, the self regulatory system will be self driven and you will be well rewarded. Any attempt to micormanage a moving system usually end in failure and frustration. Your intent is good and goal is noble but I dont think it will accomplish the goal. It usually takes 6-12 months to fully put the adrenals on track slowly and steadily in order to avoid overswinging from one extreme to another with the right personalized program because with the kind of sensitivity you have, what is right for one can be worse for another. The good news is that nothing you are saying here is unusual because we deal with similar issues with nutritional telephone coaching program daily.

      Dr Lam

  • T Welker says:

    I am diagnosed Adrenal Burnout (due to low dopamine, seratonin etc. levels) and would classify myself as Moderate to Extreme Fatigue. (not bedridden at this time, but end up there off & on) My hubby & close friends are trying to help me start an exercise program. What would 3C/3D look like? If I look above it says strengthening & toning (weights?), and beginner Yoga as well as breathing & stretching (Taichi?) I look forward to hearing from you. Thanks.

  • Noah says:

    Dr lam i am currently suffering from adrenal fatigue very bad i am only 20 years old. Ive changed my diet a long time ago and eat pretty well and take vitamins and minerals. I also am taking hydrocortisone but it works good sometimes and sometimes it makes me feel worse please offer me some advice

    • Dr.Lam says:

      hydrocortisone is a drug of last resort. if it is not working well, talk to your doctor. Sometimes the body can reject it, or develop tolerance, or the dosage may not be correct for you. There are many variables. We find many good natural alternatives and do not see the need for this in the vast majority of situation.

      Dr Lam.