Updated 02/26/2023

When Traci came to my clinic for the first time, just like so many of the women who find their way to me, her biggest complaint was utter exhaustion.

“I can’t even remember what it felt like to have energy,” she told me.

When I hear this from women, I know that it’s time to check their adrenal function.

Those who have been following me for some time know that adrenal fatigue is one of my primary areas of focus.

But something else I think is really important to understand is that there are all kinds of different factors and other underlying imbalances that can contribute to adrenal dysfunction.

In other words, adrenal fatigue is not a condition that just emerges alone. To successfully treat adrenal dysfunction and prevent it from recurring, we have to take a look at what else is going on in someone’s body that may have (at least in part) led them to this state in the first place.

One factor that is widely overlooked is mitochondrial function, and that’s what I want to get into today. It might sound intimidating at first, but supporting the mitochondria is actually quite manageable and can be very effective when it comes to healing from adrenal dysfunction and fatigue more generally. So let’s dive in!

Adrenal fatigue: the basics

You’ve probably heard of adrenal fatigue, and you may have heard the debate about whether or not it’s a “real” condition.

Many conventional practitioners dismiss the idea of adrenal fatigue, and will only recognize adrenal dysfunction at its worst – when it checks the boxes for a more serious condition.

A lot of the problem people have with the idea of adrenal fatigue as a legitimate diagnosis stems from a misinterpretation of the term. I focus on the fatigue, which is often the worst symptom of this condition we’ve come to know as adrenal fatigue.

And often, that fatigue is caused, at least in part, by dysfunction in the adrenal glands, leading to impaired cortisol production and hormonal imbalances. So in that way, the term makes a lot of sense.

Perhaps if we called it “fatigue due to adrenal dysfunction” there would be less debate over whether or not it exists.

Whatever we call it, there are very real symptoms that result from dysfunction in the adrenal glands. Unfortunately, conventional medicine tends to treat the symptoms without ever considering what’s causing them – usually with a prescription.

And even alternative medicine practitioners can sometimes default to essentially covering up the problem with supplements. But when you do so, you’re missing the big picture.

I, like most functional medicine practitioners, explore what led to the dysfunction in the first place.

And there’s something that we haven’t talked about nearly enough which certainly contributes to adrenal gland dysfunction: our mitochondria.

What are mitochondria?

Biology class may be a distant memory, leaving you wondering what the heck I’m talking about when I say mitochondria. So let’s take a moment to refresh your memory.

Mitochondria are organelles (subcellular structures with a specific job or jobs to perform) that reside in cell membranes. Mitochondria generate a majority of the chemical energy necessary for proper cell functioning. This energy is stored in adenosine triphosphate (ATP) molecules.

Some cells (particularly muscle, liver and brain cells ) require a lot of ATP. Don’t forget that your heart is a muscle, so it also needs a lot of ATP to function properly. If the mitochondria aren’t capable of producing the ATP these cells need, the cells themselves are weakened and/or destroyed.

Without proper energy, cells cannot survive. That means that healthy mitochondria are key to our good health, including the aging process.

Damaged mitochondria is directly connected to a wide range of symptoms, especially fatigue. That’s because some parts of your body are working overtime with few resources just to help you survive. Other functions not directly linked to survival are set aside.

Though survival is possible when certain systems aren’t working to full capacity (like your thyroid, adrenal glands, digestive system, and immune system) you certainly won’t feel well. And mere survival is no substitute for a healthy life!

Mitochondrial dysfunction is a leading cause of decline we’ve come to think of as “normal” aging, such as changes to our skin or reduced energy levels. Degenerative diseases such as Alzheimer’s, Type 2 diabetes, heart failure and cancer have also been linked through research to dysfunction in the mitochondria.

The good news is that this understanding brings great opportunities for us to reverse the impacts of aging and keep our bodies healthy for a lot longer than we used to think possible.

There are plenty of ways to support mitochondrial function and avoid disease.

Mitochondria and fatigue

Before we get deeper into the connection between mitochondria and adrenal function, it’s worth noting that mitochondrial dysfunction has been linked to the development of other conditions involving fatigue and brain fog, such as Chronic Fatigue Syndrome. More recently, it’s even been implicated in long COVID.

I think this is important to understand, in large part because adrenal fatigue may overlap with some of these other conditions, and/or the labels may be interchangeable by some physicians.

For example, Chronic Fatigue Syndrome is diagnosed when a clinician has ruled out other causes of extreme and long-lasting fatigue. One practitioner’s CFS might be another practitioner’s suspected adrenal fatigue.

But at the end of the day, if we know that mitochondrial dysfunction can contribute to fatigue in all of these different conditions, then it’s reasonable to consider how to support our mitochondria any time this symptom becomes problematic.

How does mitochondrial damage impact adrenal function?

Mitochondria are important to proper adrenal function since they are where the process of synthesizing the steroidal hormones produced by the adrenals begins.

Cholesterol is converted to pregnenolone, which then creates a range of hormones including DHEA, estrogen, progesterone, testosterone, and cortisol.

Logically, then, if mitochondria aren’t functioning as they should, adrenal hormone production is reduced and can become imbalanced.

If this goes on too long, you’ll progress through the stages of adrenal fatigue until you become so exhausted you can barely function.

What causes damage to the mitochondria?

Once again, in functional medicine, we’re always looking for the root cause. So, if mitochondrial damage is a contributing factor to adrenal fatigue, the next logical question is: what causes this mitochondrial damage?

As with most health concerns, there isn’t one single answer. It’s a combination of factors – and a lot of them also lead to adrenal dysfunction and hormonal imbalance. So when we support our mitochondria, we’re supporting the healthy function of these systems.

Inflammation is a leading factor in mitochondrial damage, and a common cause of inflammation is poor diet. Eating too much sugar and other inflammatory foods (like all processed foods) leads to nutrient deficiencies.

When your mitochondria don’t have the nutrients they need, they can’t produce the energy that your body requires. If you have Lyme disease, co-infections, or other viruses, this can cause mitochondrial damage as well.

Problems in the digestive system, particularly leaky gut, can also lead to mitochondrial damage as nutrients aren’t easily absorbed.

Stress leads to nutrient deficiencies as your body uses up resources simply to survive. Poor habits are another strain on mitochondrial health.

Tips for Supporting Mitochondria for Adrenal Health

Since mitochondria produce the energy your body needs to carry out vital functions of multiple systems, supporting the health of these mitochondria also supports the health of these other systems.

While some of these supports are short term efforts to restore mitochondria to top health, many of these tips are lifelong changes you can make to your habits and lifestyle to keep your body healthy over the long term.

Stick to an anti-inflammatory diet

Diet is always my first go-to solution. What we choose to eat has more power than any other lifestyle change.

We know, logically, that healthy food leads to a healthy body. But it’s easy to get caught up in convenience or old habits.

If you’re feeling exhausted already, it’s even more important to eat in a way that will support the mitochondria and restore your energy.

Protein, bright-colored vegetables and fruit, and foods high in essential fatty acids (found in wild caught fish) are all top choices for supporting your mitochondria. (Color on your plate).

Equally important is avoiding refined carbohydrates and sugary beverages that tax your system.

Heal your gut

Digestive problems create stress on your system. Addressing any imbalances in your gut bacteria can be an important step in restoring mitochondrial health. Both prebiotic and probiotic foods can help, as can a high-quality probiotic supplement. Healing your gut naturally is an important step in restoring mitochondrial health.

Address stress

All too often, women tell me there’s nothing they can do to reduce stress in their lives. They have responsibilities they say, to which I answer “Your first responsibility is to yourself.”

You cannot provide support for others without supporting your own needs – and your body can only take so much stress before it shuts down, forcing you to pay attention. You can avoid this collapse by heeding the early signals and finding ways to ease the stress.

Examine what actually must get done, and what is a result of your own (perhaps too high) expectations. Devote at least a few minutes each day to something you want to do, not have to do.

Seek out emotional support, from trusted friends or a professional therapist. Use forced waiting times (in traffic, or in lines) to take a few deep breaths.

Change when you eat

Research has demonstrated that a shorter window of time for eating each day (8-10 hours) can help your mitochondria adapt.

Many of my clients find that intermittent fasting helps them not only feel better, but lose weight as well. Of course, this doesn’t change the fact that you need to choose high quality food to provide your body with the fuel it needs.

Engage in physical activity daily

Staying active is essential for increasing oxygen intake, which has a large impact on mitochondrial health. As you use energy, your body produces more mitochondria to meet increased demand.

This doesn’t mean you have to take up running, high impact aerobics or other vigorous exercise. In fact, if you have adrenal dysfunction, it’s important not to overdo it.

But 30 minutes a day of stretching, core exercises, strength training, low impact aerobic exercise and balance work can make a big difference!

Allow yourself to rest

This is sometimes the hardest step for the women I work with.

Take Traci, for example. When she told me how exhausted she felt all the time, I asked her what her sleep schedule looked like.

She told me that she needed so much time to get through all of her work and home responsibilities that she could often only squeeze in five or six hours of sleep.

Because she wasn’t getting proper sleep, her body wasn’t able to properly detoxify and rejuvenate. Your body needs 7-9 hours of sleep each night to perform at its best.

Create a sleep schedule that allows for this essential rest, and stick to it, even on weekends, whenever possible.

While this may seem nearly impossible at first, getting the rest you need will allow you to be more efficient during the day, and you might just find yourself getting things done with time left over!

Support your body with supplements

Supplements alone aren’t enough to keep your system working at its best, but they are a terrific source of support while you heal.

It’s incredibly difficult to get all the nutrients you need from the food you eat, and if your mitochondria have been under attack for a long period of time, you need even more nutrients to heal.

I recommend an essential fatty acid supplement, a high-quality multivitamin, and any targeted support your healthcare practitioner recommends based on your individual needs.

Adaptogenic herbs, and adrenal or thyroid specific supplements can be useful as well.

Restore your energy to enjoy your life to its fullest!

Women like Traci are astounded to find how great life can be when they change a few small habits and give their bodies the support it requires.

Even older women who have resigned themselves to the downfalls of aging recognize that what they’ve been led to believe simply isn’t true. Declining health is NOT an inevitability as we age.

We simply need to know what we can do to give our bodies – including the mitochondria – what they need. When we do, we discover better health, vitality and more energy than we may have dreamed possible!

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