Adrenal Fatigue Behind Dysregulated Cortisol and Weight Loss Obstacles – Part 1

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



You need to eat healthy to fix cortisol and weight loss difficultiesOur nation’s health has been on a decline and our weight has been increasing. Many people want to lose weight permanently, quickly and easily, but there are no short cuts. Losing weight requires permanent lifestyle and diet changes and understanding the connection between the adrenals, cortisol and weight loss. This is not something that is achieved overnight. That will not change, but there are things that you can do to help kick start the process.

3 Principles for Rebalancing Cortisol and Weight Loss

1. Reduce Appetite

One of the most important elements to losing weight is to reduce your appetite. Your brain has a circuit, which controls hunger and generates cravings for just about anything, including snacks, meats, sweets, and many others. The functionality of the circuit is still unknown, but it is there and certainly plays a key role in the foods you consume. Just as with habits, such as smoking or drinking, your brains circuitry desires certain things, especially when it has had its first taste of those things and decided that it was good. The brain then decides it wants or needs it and triggers the process of cravings. This is why quitting smoking or drinking can be an uphill battle. It is no different with food consumption. Over consumption of food is a form of addiction from that perspective

Our bodies are quite complex, with many functional elements and processes. Most are simply routine functionality, stimulated and controlled from the brain’s neuroendocrine system. However, food consumption is an optional element, based on your responses to the signals. There is no set way to function with food consumption; it is controlled by what you do under the direction of the autonomic nervous system (ANS). The brain desires pleasures, such as eating certain foods or having sex. These elements are controlled by what you do, not by an automatic system of operation. Pleasures are essential to your brain’s performance through satisfaction. It is an essential element to thriving. However, understanding how to read your brain and take action can be tricky. Especially since nature throws an irresistible desire to the body to pursue them and desire them intensely.

With the ongoing challenges of food cravings and desires, there are several important methods to reducing your appetite.
Adrenal Fatigue sufferers need to drink plenty of water

  1. Drink liquids, preferably water with lemon slices, when feeling hungry.
  2. Eat five small-portioned meals a day. This controls appetite and allows the body to process the food better.
  3. Eat vegetables, small amounts of whole grains (such as quinoa, barley, millet, and buckwheat), and meats at three meals to help control hunger. Use fruits, nuts, and seeds for snacks.
  4. Eat slowly and chew thoroughly. This helps allow more time for the brain to process the satisfaction of hunger.
  5. Avoid sugar in foods. This helps prevent the rising of blood sugar levels in many people, which increases appetite. It also prevents tiredness, which can help control weight levels because you stay active.
  6. Take supplements (see below) to help with suppressing your appetite. Supplements help focus in on the elements that lead to hunger.
  7. In cases with Adrenal Fatigue Syndrome, it is also best to rotate your supplements with different types, in order to allow the body to properly use and process the various nutrients and the liver sufficient time to clear the metabolic by products out of the body.
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Supplements to Consider for Appetite Suppression:

Garcinia Cambogia helps suppress the appetite by containing the extract known as Hydroxycitric acid (HCA.) HCA increases levels of serotonin, which is a neurotransmitter inside our brains that makes us feel good. Low levels of serotonin in the brain can lead to depression and the feelings of anxiousness. Higher levels of serotonin, promoted by Garcinia Cambogia, helps the brain deal with stress that often leads to overeating. It also makes the brain acknowledge it is full sooner, leading to a reduction in eating.

Saffron (Crocus sativus L) also helps suppress the appetite by increasing serotonin levels, leading to the control of your appetite. It also helps with emotional eating, by making the brain trigger feel good feelings.

Caralluma fimbriata helps suppress the appetite by controlling the hunger sensitivity of the hypothalamus. The hypothalamus, located within the brain, is used to send signals, which tells the body that it is full. Caralluma fimbriata promotes this signal, leading to the suppression of the appetite.

Metabolic Syndrome

Those with blood sugar issues may also have cortisol and weight loss issuesHypoglycemia (low blood sugar) is common with Adrenal Fatigue. This is normally due to the combination of low cortisol and high insulin levels when the body is under stress. The normal stress response by the adrenals is to increase the blood glucose level. Glucose release is slowed as the output of cortisol reduces in adrenal exhaustion. This slowing, along with a high insulin level, leads to an increased demand for glucose. Ultimately, this leads to hypoglycemia with common symptoms of dizziness and fainting. As cellular energy demand is not being met by blood glucose, the body will turn to protein and fat as sources of energy. This pathway is not quite as efficient so the body is put on overdrive in order to provide the required energy. This increased demand is difficult or impossible to meet without adequate cortisol levels to elevate blood sugar levels by facilitating the conversion of glycogen, fats, and proteins to new glucose supplies. Clinically, one of the hallmarks of Adrenal Fatigue is a state called reactive hypoglycemia, when the serum blood sugar is normal but symptoms of hypoglycemia can be severe. In the presence of increased insulin and decreased cortisol, the blood sugar level drops rapidly, and frequent small meals are needed to replenish the body’s energy needs.

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Hypoglycemia itself is a significant stress on the entire body, and especially on the adrenals. While this can be overcome with a sugar fix consisting of an instant load of sugary drinks such as juice or soda, this is only a quick-fix remedy. Usually the symptoms will disappear immediately, but then return after 1-2 hours. Reactivation and restoration of normal cell functions require extra amounts of energy beyond what is normally required for the maintenance of normal energy burn. With each hypoglycemic episode, more cells are damaged. Thus, the body reaches a new low with each incidence of hypoglycemia. If this happens at the same time as the demand for glucose increases, the stage is set for an adrenal crisis. With each plunge, the Adrenal Fatigue Syndrome increases and reactive hypoglycemia worsens. By the end of the day, the person may feel nearly exhausted without having done anything. Low blood sugar levels are most likely to occur at around 10:00 AM, 2:00 PM, and from 3-4:00 PM.

Read Part 2 Now!



© Copyright 2014 Michael Lam, M.D. All Rights Reserved.




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19 Comments

  • Shaina says:

    What snack recommendations do you have for people who feel hypoglycemic?

  • Peter says:

    Hi Dr. Lam. I’ve followed your recommendations on diet have done pretty well. Lately though I seem to have plateaued. How can I over come this? Exercise is somewhat tiring for me.

    • Dr.Lam says:

      When you have been doing it right and plateau that usually means that there are some underlying issues still unresolved. We need to look deeper at the root cause and that takes a detailed history to put the pieces together

      Dr Lam

  • c says:

    Im very confused about diet no matter i do i dont lose weight I have since April till now on Keto diet high fat moderated protein and low carbs i haven’t lost any weight feel bloated and honestly cannot see any weight loss benefits like so many claim Im wondering what is your opinion Dr Lam..I did had some good results in the past with high protein diet low to moderated carb low fat my question is what iam doing wrong I do have all the symptoms of Adrenal fatigue also i suffer of Fibromyalgia PCOS brain fog low energy aches pains hate stress gives me pain etc I when I was a child my mom took me to a endocrinologist as I was very obese for my age and the doctor told my mom I had Adrenal gland problems ,I dont think my mom really understood what was that and how to deal with the issue never went back after that now as an adult Im struggling and my Gp doctor will not send me to see an endocrinologist a problem I have with NSH in UK is that many of the health blood test will say are normal as they dont do a full test maybe more expensive Im wondering what diet i should stick to and what herbal supplements I should take

    • Dr.Lam says:

      Everyone is different in terms of diet once AFS arrives. General principals are general and as the body gets weaker with fatigue, the metbaolism changes drastically. Without a very detailed history, any advise I give you could be wrong.

      Dr Lam

  • Frank says:

    If you follow these guidelines, eat an organic diet that is mainly vegetarian in comparison to the amount of meat eaten, and have a regular exercise routine but do not see weight loss, should you be concerned of underlying hormonal causes?

    • Dr.Lam says:

      When your hormones are not well balanced, the metabolism can be affected. If this is the case, good practices you mention may not be enough until you resolved the underlying issue. Such is the case, for example, with cortisol imbalance resulting in central obesity or adrenal fatigue.

      Dr Lam

  • Lawrence D. says:

    If I’m trying to loose weight, how can I tell it’s from proper weight loss, and not a catabolic state?

    • Dr.Lam says:

      when you are in catabolic state, you are well below your normal weight for age. the weight loss is for no apparant reason even you eat good diet. The complete clinical picture is someone who is weak and fragile.

      Dr Lam

  • Kathy says:

    7. In cases with Adrenal Fatigue Syndrome, it is also best to rotate your supplements with different types, in order to allow the body to properly use and process the various nutrients and the liver sufficient time to clear the metabolic by products out of the body.

    Can you explain exactly what you mean by “rotate your supplement”? Do you mean use a different one every few months, etc.?

    • Dr.Lam says:

      Usually that means allowing anywhere from 1-7 days to pass before using the same supplement again. Much of the exact protocol depends on the person and there is no one size fit all.

      Dr Lam

  • Rudy Crane says:

    Thanks for the info.

  • Briella says:

    With my adrenal fatigue came the ever-dreaded weight gain! Now that my adrenals have finally healed and gotten better, I am on a quest to lose all this weight! When using supplements to aid in weight loss, like Garcinia Cambogia for instance, is there a certain strength that it must be to even be effective?

    • Dr.Lam says:

      The stronger the metabolic stimulant, the faster the metabolic rate and the faster you can loose weight. At the same time, the flip side is that the stronger you use, the more at risk you are of adrenal crashes. Do consult your doctor for the best dosage that fits your state of health to avoid relapse Read Weight Loss & Adrenal Fatigue for more information. .

      Dr Lam

  • Rebecca says:

    I am morbidly obese and pre-diabetic. I have a big problem with reactive hypoglycemia due to probable adrenal fatigue. I am scheduled for weight loss (sleeve) surgery mid February and I am worried that my hypoglycemia and adrenal fatigue is going to get worse and that my bariatric doctor will not do anything for me or validate my concerns considering most doctors do not believe in AF. I am wondering if I should not have the surgery now to avoid major crashing from the stress of surgery itself and also not being able to eat much during recovery and afterwards. Usually the only way to make it through my bad hypoglycemia episodes is to have something with sugar like juice or candy but some peoples bodies cannot tolerate sugar at all after weight loss surgery. What should I do?

    • Dr.Lam says:

      Surgical risk is increased when you have metabolic imbalances. Talk to your surgeon and make sure they are aware of your condition so the appropriate approach can be taken. A healthy adrenal helps with metabolism and the earlier you embark on supporting the adrenals, the better it is.

      Dr Lam.

  • Hank says:

    Hi Dr. Lam, I know that adrenal health is important, but I really want to shed excess pounds. What are the signs I should look out for if my diet is leading to a crash?

    • Dr.Lam says:

      Everyone’s crash threshold is different, but you will likely feel more fatigue, dragging, drained, and anxious as you approach the crash .

      Dr Lam.