Can intermittent fasting cause or worsen adrenal fatigue?

by 1037 · May 04, 2012 7:02 PM

Recently I have been researching adrenal fatigue, and although I haven't done a salivary cortisol test yet, I suspect I have it, because I have almost every one of the main symptoms except weight gain, and have had these symptoms for many years now (although I am only 25). So far every single paleo or alternative health website I have visited states that intermittent fasting, or fasting for any length of time, often contributes to adrenal fatigue, and always worsens the condition once it has developed. For example, the respected paleo neurosurgeon Dr. Kruse recommends for anyone with suspected or diagnosed adrenal fatigue to never skip breakfast and to eat within 30 minutes of rising: http://jackkruse.com/what-might-casey-anthony-and-oj-have-in-common/

From what I understand, the mechanism (or at least one mechanism) of how intermittent fasting contributes to adrenal fatigue is the following: lack of protein or carbs during the time of the intermittent fast signals the liver to produce glucose via gluconeogenesis, and this requires cortisol and the catecholamines. These adrenal hormones become depleted eventually if one intermittent fasts often enough chronically, in combination with genetically weak adrenals and/or excess stress of any type (psychological/dietary/chemical/environmental).

So I am wondering: can anyone with suspected or diagnosed adrenal fatigue intermittent fast, and if so, how often and for how long each time? I want to continue intermittent fasting because of the health benefits associated with it, but at the same time I don't want to worsen my suspected adrenal fatigue. Can anyone think of a dietary, supplemental, or lifestyle compromise that would allow me to continue intermittent fasting at least occasionally while not weakening my adrenal functioning?

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77338 · October 30, 2011 at 11:47 AM

Yes, that is correct explanation. Your adrenal fatigue will become worst via the mechanism you addressed and malnutrition. It doesn't have to be that way, adrenals are plan B, first glucagon kicks in. If there is something wrong with glucagon secration [i.e. alpha cell damage or something else], adrenals kick in. See "Insulin, glucagon, and catecholamines in prevention of hypoglycemia during fasting"

The most important thing is to use vitamin C. Its role in adrenal function is well known. Its used by sportsmen to reduce cortisol levels after exercise among other things. Other then that, I suggest you multivitamin for body builders.

Other than that, you should probably avoid coffee, Camelia sinesis teas and cocoa for the time being.

Adrenal problems are frequently accompanied by thyroid problems so you need to check this too and use appropriate supplements, most notably selenium and iodine.

== EDIT ==

See my collection of adrenal and vitamin C related studies: http://goo.gl/YUA0d

155 · October 30, 2011 at 10:56 AM

I too believe that I have adrenal fatigue. After reading this article by Cheeseslave, I decided that IF was not for me at this point in my journey. ( http://www.cheeseslave.com/2011/10/17/how-intermittent-fasting-caused-my-insomnia-and-belly-fat/ ) I highly recommend that you get your adrenals healed before considering IF anymore. But I am no doctor and it is your body. Why stress the body more when it seems it is already had enough? I am currently taking this supplement to help heal my adrenals ( http://www.vitacost.com/Natural-Sources-Raw-Adrenal ). I don't think there would be any benefit in supplementing fatigued adrenals just to stress them out. =/ Good Luck!

8890 · October 30, 2011 3:50 PM

"Feeling better" at least initially, is not a good indicator of long-term adrenal health because of other hormonal factors. People feel good because they also release adrenalin. Eating or fasting at certain times of the day disrupts the normal hormonal pattern through the day. The typical pattern is to eat when you are up and about and awake, fast when you are sleeping. IF strategies that limit eating during the day and make up for it in the evening disrupt the normal pattern long after the IF. People need to read Dr. Schwarzbein before they attempt IF. I think for most people it is dangerous and hormonally disruptive. Adrenal hormone depletion is actually the last step in a whole cascade of wonkiness that fasting can cause. You don't need adrenal insufficiency to mess up the secretion pattern.

18383 · October 30, 2011 3:38 PM

"From what I understand, the mechanism (or at least one mechanism) of how intermittent fasting contributes to adrenal fatigue is the following: lack of protein or carbs during the time of the intermittent fast signals the liver to produce glucose via gluconeogenesis, and this requires cortisol and the catecholamines. These adrenal hormones become depleted eventually if one intermittent fasts often enough chronically, in combination with genetically weak adrenals and/or excess stress of any type (psychological/dietary/chemical/environmental)."

I disagree with this interpretation. Low blood sugar is responded to by glucagon to initiate gluconeogenesis, not cortisol. See my question and answer on ketosis and stress.

Also, oddly, majkinetor's answer provides more evidence of this, even though he says he agrees with your mechanism. I think maybe he is saying that fasting in combination with some kind of glucagon disorder would necessitate cortisol intervention. That, I agree with.

367 · February 07, 2012 8:19 PM

Martin Berkhan does point to a study about increased norepinephrin (or noradrenaline, as it's called elsewhere in the world) during fasting. http://www.ncbi.nlm.nih.gov/pubmed/10837292

I suspect that during a period in which I ate only fat during the day precipitated the food hypersensitivities and other adrenal problems I seem to have now. Maybe having adrenaline go through the roof primes your system to connect the food you're eating with the fight-or-flight state as causative rather than coincidental. I'm not sure.

25 · May 04, 2012 7:02 PM

Hi, I have found that the paleo diet has improved my adrenal fatigue. I have been struggling with it for a few years even though I followed the advice of whole grains and legumes suggested by practitioners (Wilson/Lam). I ate a lot of lentils and brown bread. I I am 28 now and have been struggling with it since my early teens. I didn't know 'officially' what was wrong with me until I had a salivary test in early 2010, the level of cortisol was low throughout the day.I wasn't getting any better on this diet at all. I fast from about 6pm to 9 or 10 the next morning. Not every day but 4 times a week roughly. I think it helps because I have a tendency to overeat because I feel like I have low sugar/ low hormone, so this restriction helps.
I am so glad I have found this diet; I think my life would have been horrible had I not.

10 · May 04, 2012 6:22 PM

A few anecdotes.

I've been doing LeanGains for quite awhile now and IF longer. LG started say a year and a half ago. I started practicing various forms of IF maybe four years back. I don't suspect I have adrenal fatigue; however, I am a heavy coffee drinker.

Here are some random observations:

  • Martin is a big coffee drinker/advocate of coffee
  • he's also a big advocate of BCAAs pre-workout (perhaps reduces negative effects gluconeogenesis from lean protein? No clue -- there are studies indicating faster recovery thanks to BCAAs supplemented pre-workout)
  • he's also a huge berry eater -- like a pound a day. Vitamin C?
  • LG obviously tries to counteract the negative effects of caloric restriction on the down-days (between workouts) by having carb refeeds on workout days (and slight caloric excess)

Another big IFer has to be Dave Asprey (bulletproofexec.com).

  • Another advocate of coffee
  • Has reco'ed BCAAs if you're doing his turbo fat loss protocol (can't remember what he calls it but it would strike anyone as "extreme" IF supplemented with butter coffee)
  • doesn't do the berry thing so much, but ...
  • does seems to be an advocate of Vitamin C and iodine (and collagen, which ties to Vit. C -- not sure if that's relevant)

And well my own n=1 is that I find I'm supplementing with Vit. C, iodine, and have a pretty hard to skip a night craving for at least 10 oz of strawberries. Tack on maybe another cup of berries on workout days. Seriously, this berry thing is very routine for me at this point. I just can't help but wonder if it's tied to my body telling me how to balance out the effects of IF/coffee.

Anyway, not sure this will help anyone out but I wanted to chime in.

16858 · October 30, 2011 2:35 PM

This is not meant to be evidence one way or another, and might not be even related, but I've noticed on those IF days where I don't feel hunger past the 16 hours, and don't get to eat until dinner, that I feel a rapid heart rate and a slight sense of anxiousness and feel slightly out of breath.

I think what happens is that cortisol or adrenals gets squirted in order to get some fat converted into ketones, and muscle protein into glycogen to feed the brain, red blood cells, and part of the side effect of this is the rapid heart rate.

I usually IF only on days I work out, so this is only 3x a week, and I only fall into this pattern of going past 16 hours of IF rarely, maybe less than 1x/month, and that's mostly by accident or lack of hunger.

It's interesting to notice this at a high level and ask "Why the anxiousness?" and then figure out, oh right, I skipped both lunch and breakfast, and it's dinner time, best to eat something immediately. I didn't notice fatigue, or brainfog, so it was unexpected effect.

Now as per leangains, I do take about 10g of Branched Chain Aminos in the mornings that I IF, but of course, at the point to where it gets past 16 hours, I've not taken more than just in the morning. Mostly what allows me to get to that point is having coffee (some of them decaf) with coconut oil.

10149 · October 30, 2011 at 12:59 PM

i was recently diagnosed with adrenal fatigue and i was about two months into IF. i doubt the IF caused it because at the time i was feeling better than i had in the past six months. i do shift work and 18 months ago i was over doing everything in my life.

the ND had me change to 3 meals made up of half veggies, 2 snack, one fruit a day and starchy carbs after my workout. i also take a supplement call Withania Complex.

two weeks in i feel crappy again and have no idea which of the above changes is the cause. so i will be going back to that which felt good and work from there.

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