Kristen arrived in my office, like so many women before her, almost completely worn down. She told me she simply had no energy to “do life.” She was eerily calm when she said this, her voice so full of weariness that my heart broke for her. Luckily, I knew what the problem was likely to be: adrenal fatigue, compounded by insulin resistance.

The two together can create a never ending loop – high cortisol to insulin imbalance to high cortisol, around and around until a woman feels like total collapse is inevitable. Here’s some good news: It’s NOT!

Now, I’ll walk you through the basics of each condition, show you how the cycle develops, and give you some tips on what to do about it. There are natural solutions, and by taking small steps you can make a big difference in your life!

What is Adrenal Fatigue?

Your adrenal glands are small, but mighty. These little glands that sit on top of your kidneys produce a range of hormones, some of which you can’t live without.

The primary function of your adrenal glands is to help you respond to stress in order to survive. To do so, they pump out hormones like adrenaline and cortisol, which allow you to respond to stressful situations.

Cortisol helps convert food to energy, regulates blood pressure and cardiovascular functioning, reduces inflammation and manages your body’s immune response. It also activates the stress response which prompts you to fight, flee or freeze. This is a crucial response in the face of real danger. The problem is, your body perceives all stress equally, whether actual danger is present or not. And when it’s constantly responding to stress (which is ever present in our modern lives) other important functions are put on hold.

Think about when you make a phone call and are put on hold. It’s typically fine for a few minutes, but when it goes on and on the waiting can wear you down. It’s the same idea with your hormones. Your body can wait a short time for them to come back into play, but if your adrenals are constantly producing cortisol instead of other hormones, imbalances occur — including insulin imbalances that can lead to big problems.

Adrenal fatigue is what many in the functional medicine world call the issues that result when your adrenals aren’t functioning properly. They may be producing too much cortisol, or too little. Either way, a host of uncomfortable symptoms results, including fatigue, moodiness, sleep difficulties, and weight gain. Adrenal fatigue can also diminish your capacity for tolerating stress, and lead to metabolic issues and frequent infection. And that’s just a few of the symptoms that can occur!

Adrenal fatigue has many stages, and catching it early helps get your body back on track quickly. Unfortunately, conventional practitioners often refuse to acknowledge a problem until you’ve reached an extreme disease state. That’s where the controversy around the term comes from, and why so many women are left to muddle through until they simply can’t anymore.

What is Insulin Resistance?

Insulin resistance, also known as metabolic syndrome or syndrome X, is an early precursor to diabetes. It’s so widespread in our society today that it’s part of my standard protocol to evaluate women’s level of risk when they visit my practice. Often, as with Kristen, I can spot the signs before I do any tests at all. While experts estimate that 24% of Americans suffer from insulin resistance, I believe that number is even greater among menopausal women.

That’s because hormonal balance is so crucial to good health, and menopause is a time of natural fluctuations. However, insulin resistance can happen any time, even for women like Kristen who are nowhere near menopause.

Insulin is a hormone so crucial to proper functioning that your body has a very hard time balancing other hormones until the insulin resistance is dealt with.

So what, exactly, is it? Simply put, it’s your body’s inability to properly respond to insulin. When your body can’t process insulin properly you’ll feel fatigued, may experience more hunger or thirst, and (this is the symptom that brings most women to see me) gain weight and be unable to lose it, no matter what you try.

When your body can’t use carbohydrates efficiently, insulin resistance can develop. Typically, your body breaks the carbs you eat into glucose which then enters your bloodstream. This increases blood sugar levels, and your pancreas secretes insulin to get this glucose to where it belongs: into your cells to be used or stored. When insulin guides glucose into the cells, your blood sugar levels normalize again.

If your body can’t listen properly to what insulin is telling it, your pancreas increases production – it’s kind of like shouting to get someone to hear you. If the cells still don’t listen and refuse to absorb the glucose, insulin levels remain too high for too long, increasing inflammation, disrupting metabolism, and creating insulin resistance, meaning your cells just won’t respond at all.

How Are Adrenal Fatigue and Insulin Resistance Connected?

Hormones don’t act in isolation. They’re members of a large team that must work together, relying on each other to do their jobs properly to maintain balance. Unfortunately, there’s a lot that can go wrong along the way, and when one hormone changes course, the others will too.

Cortisol produces fat and muscles cells that resist the actions of insulin as well as boosting production of glucose by the liver. This means that when circumstances are ideal, cortisol counterbalances insulin, helping to keep things steady.

When cortisol levels are high for too long, insulin resistance can develop. And high blood sugar levels that result from insulin resistance is perceived as stress in the body, prompting cortisol production and keeping levels elevated. That’s the loop I was talking about earlier, and if it isn’t broken, the problem lingers indefinitely.

Fortunately, there are many natural steps you can take to break that cycle. Let’s take a look at some now.

Natural steps for healing Adrenal Fatigue and Insulin Resistance

There’s no clear answer to the question “Which comes first, adrenal fatigue or insulin resistance?” Fortunately, the steps you can take to heal from each overlap nicely. Making changes to improve one will also help heal the other.

The major changes can be boiled down to three overarching categories: diet, lifestyle, and nutritional support.

Eating for hormonal balance

To best support balanced hormones, including insulin and cortisol, you must pay close attention to what and when you are eating. The foods that are most convenient certainly aren’t the best choices.

Processed foods, fast food, and an abundance of sugar and carbohydrates can send your hormones on a downward spiral quickly. Think about a time when you’ve reached for a mid-afternoon candy bar to keep you going…how long did your energy last? Did you feel better or worse when the “sugar high” wore off?

Constantly changing blood sugar levels will place great strain on the adrenal glands. But you can keep things stable by choosing natural, whole, organic foods whenever possible. Prepare healthy snacks ahead of time so you don’t give in to the lure of the vending machines. Freeze batches of soup, prep vegetables for an easy stir fry, or use a slow cooker to avoid ordering take out at the end of a long day.

While I don’t advocate one specific “diet” for everyone, since we are all unique individuals, eating a Keto diet can help reverse insulin resistance. The low carb, high fat nature of the eating plan puts your body into a state of ketosis, producing ketone bodies that can be used for energy. There’s evidence showing that ketosis can reduce the risk of diabetes as it reverses insulin resistance.

Making changes in beverage choices can also make a big difference in the healing process. Avoid soda (even diet soda – sugar substitutes are worse than real sugar). Drink alcohol in strict moderation if at all. Alcohol impacts insulin production and can cause your body to store glucose as fat, typically in the abdominal region.

Eat on a regular schedule to keep blood sugar levels stable. Keep carbohydrates under 15 grams per meal and 7 grams per snack, with a focus on fruit and vegetables rather than grains. Be sure your meals and snacks also contain protein. Include healthy fats in your diet to help combat insulin resistance, such as salmon or tuna, eggs, and avocado.

Support your body with supplements

Since it’s exceedingly difficult to get all of the nutrients you need from food alone, high quality supplements can be an important element for healing. When your adrenals aren’t functioning properly, targeted adrenal support can put you on the right path to good health. A high quality multivitamin and essential fatty acid supplements are part of my routine recommendations for women. The right supplements can help decrease carbohydrate and sugar cravings as well. Work with a trusted professional to find the right combination for you.

A healthy lifestyle leads to healthy adrenals

The way you live your life has a direct impact on the way you feel, especially when it comes to adrenal health and insulin resistance.

Reducing stress is one of the most important things you can do to support your adrenals. This looks different for everyone, but to be effective stress reduction techniques need to be something you enjoy. Forcing yourself to meditate or do yoga when they simply don’t work for you actually increases stress rather than alleviating it. Find a way to take at least a few minutes for yourself every single day. I find the quiet moments before my day begins to be a great time to reflect and just breathe.

Exercise can be a critical factor in keeping insulin levels normal, balancing other hormones, and regulating metabolic function. If your adrenals are strained, it’s best not to make your exercise too vigorous, so you can skip the spin class and take a brisk walk instead. If you are just getting started, try walking up and down your stairs a few times each day, or setting a timer for five minutes and marching in place. Any movement counts!

Don’t neglect to address emotional health. Emotional stress is just as hard on your body as physical stress, especially when you’ve been hanging on to it for years. Emotional distress can send you straight to “comfort foods” which often come in the form of carbohydrates, leaving you more susceptible to insulin resistance as well.

Don’t let adrenal fatigue and insulin resistance rob you of good health

When you understand how your body responds to stress you have the power to change the results. Kristen began to shift what she was eating and found ways to reduce stress in her life, and came back to me radiant and ready to “do life” again. Taking small steps towards a healthy diet and lifestyle can break the cycle of adrenal fatigue and insulin resistance, leaving you ready to enjoy life to its fullest!