Adrenal fatigue: The best methods to increase cortisol naturally

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Hormetheus

Member
Hey, I am a final year medical student. For years I had life-impairing fatigue due to low-cortisol issues.

After doing a LOT of research, I collected a list of methods we can try to raise our cortisol naturally and therefore to help get rid of HPA-dysfunction. I share this here because I am sure that I am not the only one struggling with low cortisol.

I hope you find value in this list. The following list is not like the many bullshit-lists circulating everywhere around the Internet intended for nudging you towards buying someone´s shitty product. Each single point on this list works. However, keep in mind that while many points on this list are incredibly simple, they are easier said than done.

Here is a list of things we can do to improve cortisol naturally:


  • Make sure we get blue light in the morning and avoid (excessive) amounts of blue light at night.

  • Make sure we are not taking too much melatonin.

  • Eliminate any chronic stressor as much as possible (e.g. caloric restriction, infection, regular fasting, allergies, excessive exercise, bouts of hypoglycemia).

  • Make sure we are not sleep-deprived. At first, sleep deprivation increases HPA-activity but over time it can lead to HPA-dysfunction, adrenal fatigue and burnout in the same way other chronic stressors do.

  • We should make sure our general levels of stress are not too extreme for too long. (Although as vertebrates who evolved to live in the wild, we should naturally be quite resilient and able to tolerate a fair amount of stress.).

  • Maintaining too low levels of body fat, prolonged caloric restriction, intermittent fasting, a ketogenic diet, excessive exercise can all lead to “adrenal” fatigue and burnout. All via the same mechanism. → Burnout

  • Bouts of hypoglycemia. One of the main functions of gluco-corticoids is to maintain adequate levels of blood glucose. Consequently, hypoglycemia (low blood sugar) stimulates the HPA-axis from within the brain stem and hypothalamus. Recurrent bouts of hypoglycemia over time (e.g. with intermittent fasting) can cause HPA-dysfunction, the same way it occurs with other things causing “adrenal” fatigue/ burnout.

  • Having a healthy amount of physical activity in our life. Any physical activity naturally stimulates HPA-activity, which (might) adapt to a higher setpoint over time.

  • Make sure we have no night-time stress. This increases cortisol secretion at night, which, firstly, impairs sleep quality and architecture, and secondly, night-time cortisol leads to negative feedback, reducing the HPA-activation in the morning impairing the cortisol awakening response (CAR).

  • Make sure we get enough sleep. Sleep deprivation disrupts hypothalamic signaling to peripheral glands.

  • Make sure we do not exercise excessively.

  • Make sure we have no vitamin or mineral deficiency. (e.g. vitamin B12, vitamin D, iron, zink, magnesium)

  • Forget about all the lists of “super-foods” and “super-supplements” to improve cortisol “naturally.” Most of them are a scam. Others, at most, will give a gain in the single-digit % range. (But there is a list of supplements I do recommend. See here.)

  • Make sure we are not taking any molecules that interfere with hormone signaling or production. (e.g. opioids, weed, alcohol, some prescription drugs).

  • Make sure that we did not have any major (or minor) head trauma. Head trauma (e.g. football, military, boxing, etc.) is a common, but neglected cause for hormonal problems. During a major (or minor) blow to the head, the axons making up the pituitary stalk often break, sometimes causing permanent hormonal deficiencies (or a slight reduction in one or more hormones, which often remains subclinical for the rest of the individual’s life without anyone ever getting to know.) If this is the case, there is not much “natural” stuff we can do other than going down the replacement route.

  • Make sure our caloric intake and insulin levels are not too low. This point is incredibly important (and common). Read Section 5 here.

  • Two supplements that might help slightly are ashwagandha and Rhodiola. Both seem to have serotonergic properties and the 5HT2A-receptor stimulates hormone production throughout the hypothalamus. What is more, anything serotonergic decreases (perceived) stress, therefore they facilitate recovery from stress-induced hormonal decline.

  • Licorice root is another option to “naturally” bring up cortisol levels (Glycyrrhizic acid inhibits HSD-II, an enzyme that mediates cortisols breakdown into cortisone).

  • Cutting out caffeine. Firstly, caffeine stimulates the HPA-axis, which just adds fuel to the fire if the HPA is already “stressed out”. Secondly, caffeine specifically interferes with sleep architecture and suppresses the cortisol awakening response. (In fact, caffeine-addicted people are often useless and “zombies” before they get their first cup of coffee in the morning, simply because without it, cortisol does not rise adequately.)

  • Supplementation with small doses of pregnenolone, a precursor to other steroid hormones, theoretically should elevate adrenal hormones slightly (At the end of the day 1$ is 1$.) because with its supplementation more substrate for cortisol, DHEA, and aldosterone synthesis is available (and other 60 or so expendable steroids synthesized by the adrenal glands). Thus, theoretically, this should “support” the adrenals in their effort to meet the cortisol demands and thus should help with recovery from adrenal fatigue/burnout. However, in most people, the benefit is very modest at best…but worth a try. For a more detailed discussion on pregnenolone and how to best supplement with it, see see How To Replace Non-Major Hormones: An Ultimate Guide”.


Replacing cortisol is hard, and very few doctors know about it. Because there is just SOOOO much misinformation about cortisol, I wrote a guide about how to check for low cortisol and replace it in a safe and effective way. The points listed above are an excerpt about the guide I wrote on how to cure burnout/adrenal fatigue and also -if need be- how to replace cortisol in the best/safest way. Had I known then what I know now it would have saved me lots of time, money, effort, suffering.

I hope some of you find value in it. Enjoy.

How to replace cortisol. The Ultimate Guide.

So, in case you have been or are suffering from adrenal fatigue, which of the points listed do you found most useful? I´d be interested to hear about the experience of others.
 
Last edited:
Defy Medical TRT clinic doctor

JA Battle

Well-Known Member
I like this guy a lot, we had a nice engaging video conference about hormone replacement. I’d say to anyone who has been on hrt for a while and only had mediocre results or is still struggling to dial themselves in, consider reaching out to this guy for an organized set of all encompassing information as far as hormones are concerned.
 

Sean Mosher

Member
Excellent post.
I have the exact same issue and have had for years.
Thanks for posting!

(Getting dialed in for me at first was a nightmare as this was overlooked)
 

ajax31

Active Member
Personally, I have found that pre-formed vitamin A in the form of retinol is essential to adrenal function and steroid production. The only practical source of retinol is to eat liver, or take dessiccated liver supplements.

Beta-carotene found in vegetables is poorly converted to retinol in the body (only 3%). Genetic variations (which I have according to my 23andMe) can reduce this conversion to retinol even further. The rate of vitamin A deficiency is probably a lot higher than is commonly believed when you take into account how little pre-formed vitamin A people actually consume. Very few people eat liver on a regular basis, and it's even difficult to find at stores like Sam's Club.
 
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Fernando Almaguer

Well-Known Member
Ok great post, super informative and I did not know most of the wisdom so thank you!

A couple of points may need some clarification. For example, fasting- if we have high insulin levels and insulin resistance. The stress that fasting causes is quite necessary when following a protocol to lower Hba1c correct?

Also, the blue light in the morning is confusing because we've recently heard that direct photon exposure from sun rise in the morning (not through a window) is the best way to set our circadian rhythm and wake up so to speak. More blue light during the say sets us up for sleep failure at night.

Another way to wake up in the morning that many have found helpful are warm showers first then switching to full cold shower for at least 30 seconds. This increases adrenaline and dopamine, While increasing stress response and immune function.

Any thoughts or comment?
 

lukas_az

Member
i checked out your article supplements everybody should take.
going off on herbals because they are not researched while advocating on pharma stuff because 'it is pure' is outright dangerous.
which tells me that none of your advice should be considered
 

JA Battle

Well-Known Member
i checked out your article supplements everybody should take.
going off on herbals because they are not researched while advocating on pharma stuff because 'it is pure' is outright dangerous.
which tells me that none of your advice should be considered

haha oh brother
 

Hormetheus

Member
Ok great post, super informative and I did not know most of the wisdom so thank you!

A couple of points may need some clarification. For example, fasting- if we have high insulin levels and insulin resistance. The stress that fasting causes is quite necessary when following a protocol to lower Hba1c correct?

Also, the blue light in the morning is confusing because we've recently heard that direct photon exposure from sun rise in the morning (not through a window) is the best way to set our circadian rhythm and wake up so to speak. More blue light during the say sets us up for sleep failure at night.

Another way to wake up in the morning that many have found helpful are warm showers first then switching to full cold shower for at least 30 seconds. This increases adrenaline and dopamine, While increasing stress response and immune function.

Any thoughts or comment?
If you have insulin resistance, than fasting is a great way to combat that and would not stress out the adrenals too much.

Of course the sun is better but for many of us getting sunlight is either a nuisance (e.g. going outside) or not on the cards.

Yes, cold showers wake us up, but they do not help much with improving levels of cortisol in a sustainable way.
 

Hormetheus

Member
I like this guy a lot, we had a nice engaging video conference about hormone replacement. I’d say to anyone who has been on hrt for a while and only had mediocre results or is still struggling to dial themselves in, consider reaching out to this guy for an organized set of all encompassing information as far as hormones are concerned.
Thanks for the kind works! I appreciate you getting value out of our conversation.
 

Hormetheus

Member
Thank you a lot. Using 10k I worry about my eyes being damaged, is there any serious concern regarding that?
No, damage comes from the UV-part (specifically all wavelengths below about 400nm). however, LEDs emit wavelengengths in a narrow blue-light range. No damage from that unless you are really close for a really long period of time
 

Gingkohagane

New Member
No, damage comes from the UV-part (specifically all wavelengths below about 400nm). however, LEDs emit wavelengengths in a narrow blue-light range. No damage from that unless you are really close for a really long period of time
Thanks man. I heard yesterday that you can supplement carotenoids to create a "UV protection shield" within your retina. What do you think of that? I didn't see any carotenoids in your supplement guide (Great one btw)
 

Hormetheus

Member
Thanks man. I heard yesterday that you can supplement carotenoids to create a "UV protection shield" within your retina. What do you think of that? I didn't see any carotenoids in your supplement guide (Great one btw)
It is somewhat true, however I believe the effect is super low value bc if you are not directly staring into the sun (which you should not) then endogenous antioxidants should easily take care of the oxidative stress created by the occasional high-energy photon :)
 

Hormetheus

Member
Update: Another method for elevating cortisol that works well for many:
CT3M. Waking up a few hours earlier and taking T3 (or NDT) and then going back to sleep. For some reason, this seems to work for many
 

Hormetheus

Member
FYI, at the moment I am off the cortisol completely (3 months now) and seem to be doing fine. Process of weaning was way easier than imagined. It seems that these years of cortisol replacement have somehow kickstarted my HPA again instead of suppressing HPA-function (as one would assume)
 
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