Frequent Urination and Symptoms of Adrenal Fatigue

By: Michael Lam, MD, MPH

A woman trying to hold her bladder, an unfortunate situation for those with symptoms of adrenal fatigue/The medical term for frequent urination is polyuria, and it is a condition that many regular people have. Some people need to urinate six or seven times a day and others have to urinate at least once every one or two hours. This can be among the symptoms of adrenal fatigue.

There are many causes of frequent urination. If it is accompanied by fever and lower abdomen discomfort, it could be a urinary tract infection. Another very common cause of frequent urination is diabetes mellitus, more commonly known as Type 2 Diabetes. The high levels of sugar in the blood cause an osmotic effect, which leads to an increase in urination. Type 1 Diabetes, or diabetes insipidus (DI), also frequently presents with polyuria. People taking water pills for congestive heart failure or high blood pressure management often also see an increase in urination. These are medical conditions that conventional medical doctors are quite knowledgeable about.

However, when frequent urination is accompanied by extreme tiredness, one must always consider adrenal fatigue. Adrenal fatigue is a complex condition that can affect almost every organ in the body. The adrenal gland is responsible for making several hormones, including the sex hormones, sympathetic hormones and cortisol. Another very important hormone manufactured in the adrenals is aldosterone, which regulates the level of sodium and water in the body. In adrenal fatigue, the levels of aldosterone may not be optimal. When the levels of aldosterone are low but still within standard laboratory ranges and standards, frequent urination can manifest as one of the symptoms of adrenal fatigue. Another very common but unrecognized cause of frequent urination, related to adrenal fatigue, is stress.

What is aldosterone?

Aldosterone is a steroid hormone made in the outer layers of the adrenal gland. The levels of aldosterone are regulated by the body’s levels of sodium potassium, as well as other hormones made in the brain. It plays a critical role in the regulation of blood pressure and sodium conservation in the body, because water follows aldosterone. The higher the body’s levels of aldosterone, the higher the body’s sodium levels and the water load; thus less is secreted. This reverse of this process also holds true.

Some patients receive prescription medications to lower their blood pressure by blocking the actions of aldosterone.

What happens when aldosterone activity is low?

Low aldosterone, one of the symptoms of adrenal fatigue, can cause low blood pressureHypoaldosteronism is a medical disorder associated with low levels of aldosterone. There are many causes of this disorder, including adrenal gland failure, cancer, use of certain water pills, infection of the adrenal gland, and use of certain blood pressure medications. When low aldosterone levels occur, there is a significant loss of sodium in the urine. This can result in dehydration and a drop in blood pressure. The individual will develop extreme fatigue, lethargy and can even go into shock. These changes can be prevented by increasing one’s intake of sodium chloride, also known as table salt.

Can frequent urination be among the symptoms of adrenal fatigue and stress?

Yes, there are some people who experience mild to moderate stress who can develop frequent urination as one of their symptoms of adrenal fatigue. The stress may be physical or emotional. Because the control of aldosterone is partly under the influence of the brain, any type of nervous stimulus or mental stress can affect its secretion. When an individual has physical stress, there is increased release of the stress hormones, such as epinephrine, norepinephrine, glucagon and cortisol, all of which can affect urination. Short-term stress causes your body to release epinephrine. In turn, epinephrine can increase urine flow. Under chronic stress, cortisol levels will increase in early stages of adrenal fatigue (stages 1 and 2). These increased levels as one of the symptoms of adrenal fatigue cause an anti-diuretic hormone (ADH) to decrease, thereby, once again, increasing urine flow. As your adrenals continue to get stressed, cortisol levels may drop. However, as the adrenals weaken further into advanced stages (stages 3 and 4), they will also become unable to produce aldosterone at the proper levels. A decrease in aldosterone will once again result in an increase in urination as one of the symptoms of adrenal fatigue. So, in the early stages of adrenal fatigue, cortisol levels and epinephrine levels in your body may be higher, leading to frequent urination. In the later stages of adrenal fatigue, the adrenals are not able to produce aldosterone, thus resulting in increased urination as well. The end result is increased urination, loss of sodium and extreme fatigue, while dehydration can occur as adrenal fatigue advances, but for a different reason.

How does one get to the root cause of frequent urination?

Because there are so many causes of frequent urination, the medical practitioner will need to do an exhaustive work-up. Before attributing the condition to adrenal fatigue, one has to rule out other, more serious, medical conditions. It can be difficult for a healthcare provider to make a correct diagnosis linked to frequent urination, based on just the history and physical exam. Before a diagnosis can be made, your provider may ask you the following questions:

  • Are you taking any medications, herbs or supplements?
  • What other symptoms are you experiencing?
  • Does the urination occur during the day, night or all the time?
  • Are you more thirsty than usual?
  • Is your urine dark, clear or bloody?
  • Do you drink a lot of coffee or alcohol?
  • Do you have a fever?
  • Do you have abdominal discomfort when you urinate?

Depending on your answers, the provider may take the following next steps.

  • Analyze your urine for bacteria, stones, glucose, acidity, levels of sodium, potassium, etc.
  • Refer you to a specialist to examine your bladder to make sure it is working properly and is able to store urine.
  • Order an ultrasound to make sure you have no kidney stones.
  • Order hormone level tests.

Are hormonal tests sensitive for adrenal fatigue?

Tests often cannot detect what is wrong when people suffer symptoms of adrenal fatigue/In general, the available tests are quite sensitive when there is a severe drop in the levels of hormones. However, if you have mild stress or adrenal weakness, the changes in hormone levels are often not readily identifiable by the standard of currently available tests. In other words, laboratory tests could be normal, leaving physicians at a loss to understand the symptoms of adrenal fatigue. That’s why a detailed health history as well as sharp clinical judgment is required to connect the dots and see if your frequent urination is indeed part of the constellation of symptoms of adrenal fatigue and stress or something else.

How does one overcome polyuria in an adrenal fatigue setting?

Increase hydration, but make sure that your electrolyte balance is maintained; this is key to avoiding medical emergencies as a result of dehydration from excessive frequent dehydration. Your sodium level needs to be maintained, as excessive fluid without adequate sodium replenishment can lead to a condition known as dilutional hyponatremia. This can be quite serious, with lethargy, and stupor as a potential end result. Excessive sodium replenishment, however, can lead to high blood pressure. Fortunately, this is seldom the problem because most sufferers of adrenal fatigue have constant low blood pressure. Raising blood pressure with proper fluid and electrolyte replenishment is usually accompanied by a renewed increase energy. Always carry a full water bottle with you. Hydrate frequently, before you notice the onset of thirst. When you are thirsty, the body is already well into subclinical dehydration.

Be careful to avoid drinks such as coffee that have a net diuretic effect. Talk to your doctor if you are on blood pressure medicine, to discuss possible adjustment.

Fortunately, polyuria as one of the symptoms of adrenal fatigue is one that can be reversed. As adrenal support improves and electrolyte balance normalizes, this phenomenon usually resolves by itself.

For a long-term solution, one must deal with the inciting underlying condition. For example, if the infection was the cause of damage to the adrenal gland, then one must use antibiotics. If stress is the cause, then one must take measures to relieve stress. The first thing you should do is find out what the stress is and try to reduce or eliminate it. There are several remedies to relieve stress and they include the following:

  • Exercise can help strengthen the body and lower or eliminate symptoms of adrenal fatigue/Engage in some form of mild exercise. Almost any exercise – even walking – has been shown to improve the mood and lower stress, provided you can tolerate it and have no energy slump for the next 24 hours after finishing exercise. Remember that during active exercise, the feel-good sensation is often due to an adrenaline rush. If you have adrenal fatigue, you can trigger an adrenal crash after the adrenaline is burned off. Excessive exercise is not recommended.
  • Engage socially with your family and friends. These individuals can provide you with support and make you feel safe. It is important to avoid toxic relationships that can trigger adrenal crashes.
  • Learn to say no. There is no way you can please everyone, so stick to your limits and do not take on more than what you can handle.
  • Avoid people who stress you out. If there are people who constantly irritate you, then it is time to cut them out of your life.
  • Take control of your environment. This means removing anything that brings stress. For example if the TV is too loud, switch it off.
  • Learn to express your feelings and don’t bottle them up.
  • Practice some type of relaxing exercise, like yoga or tai chi, or try meditation or massage
  • Learn to compromise and manage your time better.

Besides relieving stress on your body, it is also important that you give the adrenals the proper nutrition and attention they need to slowly recover and start producing aldosterone again.


If stress is the cause of your frequent urination, then lowering stress will show improvement in your symptoms. You need to change your lifestyle to ensure that stress is at a minimum. In most cases, stress relief can be supported by home remedies, which are generally safer than prescription medications. The next step is to make sure your adrenals are getting stronger so that they can increase their hormone production and once again bring your body back into balance. Finding an experienced clinician with this expertise is important because an improper fluid balance can have very serious negative consequences. The effects of stress relief on urination are immediate. You will also notice an improvement in your energy levels and will not feel as tired as often.

© Copyright 2016 Michael Lam, M.D. All Rights Reserved.

A woman trying to hold her bladder, an unfortunate situation for those with symptoms of adrenal fatigue/
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