Signs & Symptoms: Adrenal Fatigue and Breathlessness Causes

By: Michael Lam, MD, MPH

The adrenal glands are important to a vast amount of body functions. When they are not working properly, there may be a tremendous impact on how a person feels. The adrenal glands are linked to optimal function of four major organ systems: the heart, liver, kidneys, and digestive system, by producing regulating hormones. If these glands are not performing correctly, there is no other backup in the body that can produce the same level of hormones. If the adrenal glands become fatigued and hormone levels drop, these four areas of the body may be negatively impacted, generating a wide variety of symptoms including breathlessness causes.

A man suffering from Breathlessness Causes and clutching his chestOne of the more unusual symptoms that can result from adrenal fatigue is shortness of breath, despite results of a physical exam indicating everything is normal, including lung and cardiac function. The patient may describe feeling as if they cannot take a full breath of air, particularly upon exertion or when experiencing high levels of stress. Commonly described as breathlessness, this phenomenon is very real and can come on after climbing a flight of steps. Most advanced AFS sufferers have at one time or another had such experience, though it could be transient, if they really pay attention. The more advance the adrenal weakness, the more pronounced this can be.

Shortness of breath is one of the complaints that can land an individual in the emergency room and place them high on the priority list. The seriousness of this complaint is due to the more common potential causes – heart attack, heart failure, or pulmonary embolism. Complications of the heart or lungs are always cause for concern and immediate medical attention is warranted.

AFS and Breathlessness Causes

If there appears to be no physiological basis for any breathlessness causes, the patient may be sent home with a clean bill of health. Most likely, the problem will return and the patient will wind up demanding solutions from a puzzled physician. They may be given an emergency inhaler for temporary relief; but the problem will recur without a long-term solution.

Shortness of breath typically presents in two different situations related to adrenal fatigue. One occurs when an individual is extremely nervous with accompanying generalized anxiety. Having an episode of this heightened sense of nervousness, perhaps during a particularly frightful experience, can become one of the breathlessness causes. Being unable to take a full deep breath of air is typically associated with the symptoms of a panic attack when the person is breathing so quickly the breath volume on intake is shallow and rapid. When short, shallow breaths are taken in quick succession, it becomes nearly impossible to exhale completely, resulting in a buildup of carbon dioxide. This type of shortness of breath becomes cyclical, repeating itself, and is tied in to the release of norepinephrine and epinephrine (also called adrenaline) in the body. These hormones and neurotransmitters are released when the body is under stress, and stimulate many organs in the body, including the lungs. An increased heart rate, feelings of anxiousness, tinnitus, and shortness of breath are all unwanted side effects that can result from increasing levels of norepinephrine and epinephrine in the body.

In more advanced cases of adrenal fatigue, the client is in a catabolic state. At this point in the progression of adrenal fatigue, they have a decrease in muscle mass and are extremely lean. They have lost muscle mass in the larger muscle groups, such as the quadriceps and gluteal muscles. In addition, the muscles that hold the ribs together, the intercostal muscles, are also weak and diminishing. When a person in this condition attempts to take a deep breath, they find it difficult due to the wasting of the intercostal muscles and loss of muscle strength. When this happens, expansion of the ribcage cannot occur normally. At this point there is both a physical and structural compromise to the breathing action, and this lack of proper muscle strength becomes one of the more serious breathlessness causes. This situation is extremely rare and emergency medical attention may be required in these situations to ascertain that you are stable and able to breath on your own accord.


Someone looking up their Heart Rate on the phone, deciphering if it is related to their Breathlessness CausesAnother related problem that sometimes occurs, when the adrenal glands are not functioning up to capacity, is postural tachycardia syndrome (POTS). POTS is a type of orthostatic intolerance that occurs with rapid heart rate (typically over 120 beats per minute) and other symptoms, such as low blood pressure, when a person stands up from a sitting or lying down position. The corresponding symptoms experienced with postural tachycardia syndrome are so varied, in some individuals the blood pressure remains constant or even increases.

Additional clinical abnormalities that patients with POTS symptoms display may include low blood volume and high levels of norepinephrine while standing. Many people with postural tachycardia syndrome report feeling nauseated, fatigued, and lightheaded. Some experience heart palpitations, have difficulty concentrating, experience tremors, fainting spells, exercise intolerance, pain and coldness in extremities, shortness of breath and chest pain.

Symptoms of postural tachycardia syndrome can occur as a result of a number of different abnormalities. While some of the disorders linked to POTS symptoms are known, many of the underlying causes have yet to be identified. There are different types of POTS. In the setting of AFS, adrenergic driven POTS like symptoms are common. Most sufferers are symptomatic, but do not fit the classical definition of POTS, and tests are borderline or normal. They are usually given a clean bill of heath from the cardiologist and neurologist, while they remain clinically symptomatic. We called these subclinical POTS, where symptoms are present but laboratory test are normal.

The condition is further complicated due to the difficulty distinguishing between the cause and effects of the problem. Because there are many conditions that can produce POTS-like symptoms, it’s important that physicians seek to identify possible reasons for the syndrome, since many of the causes are reversible.

Points to Consider

Shortness of breath is a symptom that, by itself, may not be an indicator for anything more serious. While the difficulty of breathing can often be a frightening and alarming, oxygen saturation levels are typically within normal limits and the body is not in any serious danger.

The Adrenal Glands, which are key to various Breathlessness CausesWhen an individual complains of shortness of breath, and it appears that adrenal fatigue is part of the profile, the issue becomes determining whether the symptomatology is related to the progression of catabolism, or if there are other contributing factors. If postural tachycardia syndrome is an additional piece of the puzzle, the clinical profile may indicate larger issues that need addressing.

Fortunately, if the adrenals are rebalanced and allowed to recover, the catabolic process can be reversed and hormones brought back into balance as well. This will improve the entire condition of the body. Catabolism, when left unchecked can be a significant contributor to breathlessness causes, which, when allowed to continue, may cause other serious structural problems due to lack of proper lung expansion. In addition, lack of a complete breathing cycle has been known to lead to infections, such as pneumonia.

As the adrenal glands return to normal, physical strength also returns. At this point, the body’s ability to self-regulate will be improved and controlling abnormal breathing during stressful situations will be easier. Normal functioning adrenal glands will be able to produce the necessary hormones to regulate other common body functions. It is important to note that by the time most people experience shortness of breath in an AFS setting, the condition is at an advanced stage. Self-navigation usually fails and in fact can worsen the condition if one is not careful. The use of adrenal support supplementation needs to be very judicious, as small amounts of supplements can trigger the body into an adrenal crash, and set the body off in a vicious cycle of worsening shortness of breath, ending in panic attack, or severe insomnia. If you suspect you are in such a situation, consulting an experienced, AFS literate, practitioner is best.

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

Dr. Lam’s Key Questions

There are many different kinds of breathing exercise. Deep breathing or holding your breath between inhale and exhale can help to keep the mind clear. While the Adrenal Breathing Exercise helps to keep the body calm. If you have stage 1 or 2 AFS, it’s good to practice both kinds of breathing.

They are very similar, with ABE, you should not go over 80% of lung capacity, and you don’t want to hold your breath. The key is calming.

Explore how Adrenal Fatigue can cause and contribute to Breathlessness Causes
5 -
Having suffered from adrenal fatigue for many years I now appreciate that a fully qualified doctor with the understanding of this condition such as Dr Lam is priceless...his adrenal breathing CD has been immensely valuable in aiding my recovery, and his articles thoroughly cover almost every aspect of this complicated condition. I highly recommend his site to anyone suffering from adrenal fatigue.


  • Lubov Feather says:

    Hello Doctor. I have short of Breath for 3 month and getting worth…. and am so tied and upset… I have palpitation of hart … My Doctor check my heart and everything seems OK. check on asthma – I do not have any…. pulmonologist going to do mo test ….and recommend CT….But after your video it seems to me that I have Andrenal problem….what I need to do?

  • caroline says:

    Hi Dr Lam,

    So what are the next steps for someone feeling shortness of breath and lightheaded upon exertion? I notice mine comes on especially at night, and when i haven’t mentally psyched myself up for physical activity (which, you can imagine is quite often) An example is last night, when I went out to watch a ballet and I was impersonating a couple of steps on my way home and ended up feeling very strange and breathless from just a couple of twirls and prances, even though i know i am quite fit) . I thought my adrenals were recovering as i’ve been able to do far more in my life in the past few months, although the breathlessness (which i note feels very different to ‘unfit’ breathlessness) is present and a little disconcerting. Any advice welcome. Thank you.

    • Dr.Lam says:

      The next step is to report to your doctor and ask for help as that means usually there are some underlying issues not resolved. A detailed history will be helpful

      Dr Lam

  • Esther says:

    I was thrilled to read this article!! Thank you!! –My daughter, age 22 has been in a chronic state of illness, fatigue, short-of-breath, panic attacks etc.. for the past 3 years and all of the specialist we have seen have come up with nothing! No explanation or any kind of help (except to say “It’s all in her head, she needs to see a psychiatrist!”) We have been to endocrinologists as well, but they were not learned about AF, so it’s no wonder they did not explore that aspect of her condition.. We did order genetic testing for her and it showed she has MTHFR (another “Aha!” moment for me, when reading your other articles!)
    Is there any chance you know of practitioners in the Chicago area that have experience dealing with AF? Thank you in advance for any info you may have regarding this! And Thank You again for putting out these articles and information! It’s a life-saver, literally!!

    • Dr.Lam says:

      Our program is unique as that is all we do and sorry there are no other practitioners in the world as it takes decades of experieince. We do have a nutritiolnal coaching program by telephone that helps people worldwide.

      Dr Lam

      • Esther says:

        Okay, thank you! I will contact you if I can figure out a way to make a visit with my daughter to CA 🙂