2

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How long should it take to reverse the symptoms of cortisol/adrenal problems?

Answered on September 12, 2014
Created July 07, 2011 at 1:48 PM

I have noticed during the past few months that my sleep quality has deteriorated, most likely due to the combination of mild IF and heavy weight training 3-4 times per week (although I have not been training fasted and don't metcon). Diet has been 100% strict, I have little-to-no stress, get plenty of sunlight, and go to bed at a reasonable/early time... BUT I still have difficulty falling asleep without Melatonin supplementation, and wake once per night to urinate. These symptoms are noticeably worse on intense workout days, which further convince me of cortisol problems.

I have decided to take some time off of training, and am wondering how long it can take for these symptoms to resolve. I'm sure it is highly variable between people and dependent on other factors as well, but at the moment I am planning 1 full week off and re-evaluating how I feel at that point. I love my training but know how much more important sleep is!

E0250b1e6dc5ec1539ffb745042b4d80

(3651)

on February 27, 2012
at 10:21 AM

How is it that this "normal to wake up in the middle of the night" neolithic thing suddenly become Paleo and everyone seems to just believe it? No skepticism? To the OP, you probably will bounce back pretty quick. I wouldn't worry about it. Relax.

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on January 11, 2012
at 11:08 AM

Ubiquinol is extremely expensive if you take that dose though :(

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on November 20, 2011
at 05:16 AM

It already is....

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on November 19, 2011
at 06:11 AM

Excellent! This needs to be a blog poxt.

77877f762c40637911396daa19b53094

(78467)

on July 16, 2011
at 03:44 PM

If one feels messed up from using Ritalin, are you saying Zinc and copper might be low? What foods should one eat if Ritalin messed them up? how could they recover?

F3fc2e0a9577e7e481a387d917904d1e

(1070)

on July 09, 2011
at 01:51 PM

I'd say cyclic low carb; eat plenty of starchy vegetables on workout days and less on rest days.

Cbb1134f8e93067d1271c97bb2e15ef6

on July 09, 2011
at 04:54 AM

+1 Nice one, Quilt. :)

77877f762c40637911396daa19b53094

(78467)

on July 09, 2011
at 01:46 AM

Quilt. You forgot the most important thing. Add carbs.

77877f762c40637911396daa19b53094

(78467)

on July 09, 2011
at 01:45 AM

are you low carb?

77877f762c40637911396daa19b53094

(78467)

on July 08, 2011
at 01:53 AM

Just wanted to add that I have been someone who usually stays up past midnight every night and up wakes early, so my insomnia and wakefulness were starting to cause real problems. I'm thrilled to be able to affect my sleep so strongly by this one little thing.

C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on July 07, 2011
at 08:24 PM

I have type II diabetes - probably (read more than likely) had cortisol issues and definitely had sleep disturbances (not any longer though!). However, the only time I wake up to go to the loo during the night is if I'm woken up by my kids. Just my n=1's worth.

1f8384be58052b6b96f476e475abdc74

(2231)

on July 07, 2011
at 05:16 PM

i always wake up to pee

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 07, 2011
at 03:42 PM

Plus I'm in surgery between cases.........I don't have the time to give a full and complete answer. His question was about time and adrenal fatigue can take mons to get better based upon severity

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 07, 2011
at 03:34 PM

It's too long to put here. So I will do what I think is best to answer this. If he chooses to avoid it like you that is your choice. Most people like advice for free. Clearly some like you don't. I respect that.

1ec4e7ca085b7f8d5821529653e1e35a

(5506)

on July 07, 2011
at 03:15 PM

I am agreeing with ben's answer and noting that I also pee once or twice every night. I go less when I drink less water before bed, but I drink it anyway.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 07, 2011
at 03:08 PM

not an answer. completely not helpful. no one cares if you are "going to write about this issue this week." Answer here is answers, not allusions to your blog.

F3fc2e0a9577e7e481a387d917904d1e

(1070)

on July 07, 2011
at 02:45 PM

Thanks for your reply and advice. I agree my lifestyle certainly doesn't indicate severe stress, but my thinking was due symptoms worsening on intense workout days as well as this post: http://robbwolf.com/2011/06/16/clearing-up-kidney-confusion-part-deux/ (see "Hormonal Effects of Sleep"). My waking during the night is ALWAYS due to the need to urinate. I go to bed around 10:00 PM and usually wake between 2:00 - 3:00 AM. I wind down by reading and avoiding television/computer screens. Workouts are usually in the mid afternoon, around 3 PM and PWO meals are LARGE with sweet potatoes.

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6 Answers

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2
1ec4e7ca085b7f8d5821529653e1e35a

(5506)

on July 07, 2011
at 02:18 PM

If your diet is in check and your weight training is limited to 3-4 times per week I have a hard time believing that you are so stressed it's causing poor sleep.

First thing with the nightly wake-up: It is normal to wake up in the middle of the night. That has been discussed before, so see this for a starter: http://paleohacks.com/questions/43007/hack-my-night-wakings#axzz1RKSl9Gsh

On to the difficulty falling asleep. What is a "reasonable/early" bedtime for you? And what time do you usually wake up? Are you making sure to wind down before you go to sleep and start turning off lights? Are you eating more on training days for recovery purposes? How close to bedtime are you working out? What kind of difficulty falling asleep is it? More information could be helpful.

You could try upping your intake of saturated fats (as a percentage of daily fat intake) and making sure to get a good post workout meal in. Try workout recovery methods like foam rolling, ice baths, contrast showers, and the like to see if they have any effect.

F3fc2e0a9577e7e481a387d917904d1e

(1070)

on July 07, 2011
at 02:45 PM

Thanks for your reply and advice. I agree my lifestyle certainly doesn't indicate severe stress, but my thinking was due symptoms worsening on intense workout days as well as this post: http://robbwolf.com/2011/06/16/clearing-up-kidney-confusion-part-deux/ (see "Hormonal Effects of Sleep"). My waking during the night is ALWAYS due to the need to urinate. I go to bed around 10:00 PM and usually wake between 2:00 - 3:00 AM. I wind down by reading and avoiding television/computer screens. Workouts are usually in the mid afternoon, around 3 PM and PWO meals are LARGE with sweet potatoes.

1ec4e7ca085b7f8d5821529653e1e35a

(5506)

on July 07, 2011
at 03:15 PM

I am agreeing with ben's answer and noting that I also pee once or twice every night. I go less when I drink less water before bed, but I drink it anyway.

1f8384be58052b6b96f476e475abdc74

(2231)

on July 07, 2011
at 05:16 PM

i always wake up to pee

C4134ed417dbc0a6b79ab2cee32632d3

(1801)

on July 07, 2011
at 08:24 PM

I have type II diabetes - probably (read more than likely) had cortisol issues and definitely had sleep disturbances (not any longer though!). However, the only time I wake up to go to the loo during the night is if I'm woken up by my kids. Just my n=1's worth.

E0250b1e6dc5ec1539ffb745042b4d80

(3651)

on February 27, 2012
at 10:21 AM

How is it that this "normal to wake up in the middle of the night" neolithic thing suddenly become Paleo and everyone seems to just believe it? No skepticism? To the OP, you probably will bounce back pretty quick. I wouldn't worry about it. Relax.

5
Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 08, 2011
at 01:04 PM

OK Austin.......here is my full answer.

Do you have dark circles under eyes? Are your eyes sunken to some degree? Do you sleep poorly? Have you lost your energy? Sex drive gone? Do you bloat and start getting unusual bowel movements? Do you live in a plateau phase constantly? Has your weight remained the same too long? Tired for no reason? Need to drink a ton of coffee and salty carb snacks to get by? Do you still crave sweets? Do you feel generally rundown? Do you exercise a lot but still have belly fat that is resistant to loss? Are you forgetful often? Hair loss or brittle? Diagnosed with GERD (dysbiosis) and feel nervous often? Often depressed? If this sounds like you welcome to the diagnosis of adrenal fatigue. Many conventional docs don???t buy this diagnosis but that is because they can???t see what they are not looking for.

This syndrome is most often seen in middle age women and can present with multiple endocrine changes that are often confused with thyroid issues or perimenopausal changes. Men do get this syndrome and most often it is seen with dietary issues and fatigue from working out or from chronic stress.

What to look for in you: People with adrenal fatigue tend to wake up tired (low cortisol) and not wanting to eat breakfast. Most people don???t have enough fuel in their livers/muscle for gluconeogenesis to sustain the day???s needs. In this scenario if you don???t eat you are basically stressing your adrenal gland further to sustain sympathetic tone to make that energy your liver does not have. You are demonstrating poor post workout recovery. You get sick more often and your recovery from illness is slower. Usually you have bloating and signs of a leaky gut and poor immune function. Your nails will be brittle and your temps might fluctuate. Your vitamin D level falls for no reason. You will also have a lower BP and tend to feel cold most of the time. Heart palpitations and chest pain are possible as well. Women will have more premenstrual symptoms and will notice more food intolerances over time. Sometimes a contributor is emotional stress in the history. Divorce, cheating, spousal death/disability are huge drivers of this syndrome. Hypoglycemia is very common especially with activity. In women, I look for (OAT) ovarian, adrenal and thyroid syndrome that have symptoms such as PMS, low body temperature, endometriosis, PCOS, cystic breast, menstrual irregularities, fibroids suggestive of ovarian dysfunction and Estrogen Dominance; dry skin, weight gain, fatigue, low energy, blunted response to thyroid medications suggestive of secondary hypothyroidism; salt craving, frequent infection, hypoglycemia, insomnia, anxiety and adrenaline rushes suggestive of sympathetic overtone common in late stage Adrenal Exhaustion.

Stressors that can lead to Adrenal Fatigue include:

Emotional stress Chronic fatigue Chronic illness Chronic infection or autoimmune disease. Chronic pain and opiate abuse Depression Excessive exercise Fear and guilt Gluten intolerance Low blood sugar Malabsorption due to lectins and phytic acid Dysbiosis Toxic exposure to environmental stressors (Hg) Severe or chronic stress Surgery of any type Late hours for any reason Sleep deprivation or night time shift work Excessive refined sugars in diet Excessive caffeine intake from coffee and tea Chronic dental infections of periodontal or endodontic etiologies. Microcytic anemia due to copper deficiency complicated by low zinc levels.

Diagnosis: A good History and Physical is invaluable to make the diagnosis. Look for salivary cortisol levels in the AM to be very low and a reverse of the normal diurnal cortisol cycle. Patients tend to have low sex steroid hormones and flat to lower vitamin D levels and especially low DHEA levels. This is in fact my favorite lab to diagnose this condition. Total lack of sympathetic response due to low epinephrine and norepinephrine. I check this with bio-impediance (BIA) and heart rate variability loss. BIA shows a reduced phase angle on exam. HRV is diminished with testing. Patients also have low aldosterone levels and this is why they always have low BPs with increased thirst. The person who ???quantifies??? themselves with lab values will be able to diagnose themselves rather easily with a few key labs. A very positive history of dysbiosis. The dysbiosis is die to reduced secretory IgA (the main cellular defense factor), natural killer (NK) cell and T-lymphocyte activity which lead to increased chances of getting infections such as Herpes, yeast overgrowth, and viral infections.

Treatments: Adaptogens Maca, Rhodiola, Holy Basil, Black cohosh root, licorice, Fo-ti root Supplements: CoEnQ10 (ubiquinol) 400mgs to 1200 mgs, phosphatidylserine and choline, DHEA and pregnenolone replacement (all based upon lab values) Treat with high dose B complex and vitamin C replacement to help liver detoxification phase 1 and phase 2 pathways

Introduction of Mind body meditation techniques. Big thirst. Treat with hydration and salt tabs. Astragalus (Qi-tonic or TA-65) Melatonin Progesterone Complete darkness for sleep Bioidentical cortisol (hydrocortisone) Oxytocin Colostrum Replace vitamin D to minimum 50 ng/dl GABA replacement L-theanine Avoid caffeine, chocolate, ephedra, guarana, kola nut, and prescription stimulants. (Ritalin) For severe cases check Zinc and Copper levels as well. Fe levels and Hg levels in long standing cases Expose yourself to low light situations as soon as the sun sets before bed

Pearls for a Adrenal optimization:

Sleep by 10 PM Sleep in until 8:00 AM Avoid over training Do the things you enjoy Avoid coffee or other caffeinated beverages; steep your tea! Eat early within thirty minutes of rising Have a glass of water in the morning with 1/2 to 1 teaspoon of salt Avoid grains such as bread Avoid starchy foods such as potato Mind body mastery/ Laugh several times a day Take vitamin C, pantothenic acid, magnesium, and vitamin E (Mixed tocophrenols) Take pregnenolone and DHEA, as needed Avoid becoming fatigued Avoid high glycemic fruits Never skip breakfast ever

PROGNOSIS: is usually excellent Treatment with recovery time takes anywhere from 3-18 months depending upon severity of the condition at presentation. The most serious cases usually have dietary causes intertwined with several mineral deficiency and an uncorrected hormone imbalance.

77877f762c40637911396daa19b53094

(78467)

on July 09, 2011
at 01:46 AM

Quilt. You forgot the most important thing. Add carbs.

Cbb1134f8e93067d1271c97bb2e15ef6

on July 09, 2011
at 04:54 AM

+1 Nice one, Quilt. :)

77877f762c40637911396daa19b53094

(78467)

on July 16, 2011
at 03:44 PM

If one feels messed up from using Ritalin, are you saying Zinc and copper might be low? What foods should one eat if Ritalin messed them up? how could they recover?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on November 20, 2011
at 05:16 AM

It already is....

2b2c2e4aa87e9aa4c99cae48e980f70d

(1059)

on November 19, 2011
at 06:11 AM

Excellent! This needs to be a blog poxt.

B0fe7b5a9a197cd293978150cbd9055f

(8938)

on January 11, 2012
at 11:08 AM

Ubiquinol is extremely expensive if you take that dose though :(

4
667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 07, 2011
at 03:07 PM

Interestingly, though overall throughout the week my sleep quality is very good (duration of 8 hours on the nose without an alarm clock) I do indeed notice that the night of the day that I lift on the sleep is many times, though not always, less than ideal. I mean the first sleep after I???ve lifted. I usually lift M, W, and F so Monday night???s sleep etc. I don???t let it bother me but I do indeed notice it.

On the getting up to pee thing: I get up every night 2- 3 times to pee. I know people go on about how bad that is but its never hampered me in any noticeable way. I recover well enough to lift again, I feel fine in the morning, etc. Of course, you have to get right back to sleep after peeing. I just think its because I knowingly drink a lot of water and tea before bed.

I think what you???re experiencing is normal. I do not think, even if you disagree that its OK to be like this, that it???s a cortisol issue.

1
2537178be91e390c4a2c21941fbada3a

(10)

on July 21, 2013
at 04:20 AM

For Austin and all others with similar issues - I've experienced the same exact thing. I did IF training with BCAA's for nearly a year and I would always get horrible sleep the night that I trained. I, too, attribute it to an increase in cortisol due to: 1)heavy lifting in the fasted state 2)large meals (and large insulin spike) post workout.

I've since been very hesitant to work out in a fasted state (even with BCAA's). My sleep has been quite good recently so I felt like doing a heavy fasted lift. The lift was KILLER (as in great), but that night, as expected - horrible sleep. I will admit - lifting in the fasted state has allowed me to make the most progress, but it comes at a cost (poor sleep and overactive adrenals).

When I workout and lift heavy but eat something small before, these symptoms are drastically reduced, if not completely eliminated.

I also have noticed that if I only do push-ups/pullups/sprints in the fasted state, I don't have much of a problem. So I have concluded that poor sleep is primarily a result of lifting very heavy in the fasted state. Apparently this puts too much of a strain on the body.

P.S. Getting up to pee in the middle of the night is not how your body is supposed to function. Although these days, with everyone downing coffee/tea, staying couped up infront of a bright computer screen, and being exposed to bright lights shortly before bedtime, it has become "the norm". Getting up to pee 2-3 times is even worse. This is your body saying "you are doing something wrong". I would change your routine until this issue stops.

I used to have this issue when I did IF workouts with BCAAs/creatine prior to the workout. I'm pretty sure creatine probably caused me to retain more water which caused me to pee more often, but I also think the fasted lifting played a role.

I've found that I sleep the best after doing a really intense cardio workout (think: basketball for 1+ hr, biking in hills for 1+ hour, hill running for 1+ hr). I always sleep like a baby after those type of workouts. Either way, I would recommend eating something light before your workout. If you're doing a lifting workout, keep the carbs and fat as low as possible in order to maximize GH and reduce the burden of digestion. In other words, an egg white omelette and veggies would be a great choice. Prior to a HIIT/Cardio workout, add more carbs. In either case, keep the meals relatively small. One truth to the IF workouts is that you want to get the bulk of your calories after the workout. It not only helps with recovery but it also will prime your mental state during the workout. Best of luck.

1
77877f762c40637911396daa19b53094

(78467)

on July 07, 2011
at 03:03 PM

Don't know if this will help but for the past few days I've been really avoiding lights in the evening by not turning them on at all! In other words when I get home from work I fix dinner and do stuff in the natural light of the longer summer days. When it gets really dark around 9pm I just get into bed and am immediately sleepy. I probably fall asleep by 9:30pm and stay there until around 6am. I couldn't believe how well this worked! Plus even if I got up once in the middle of the night I just fell right back to sleep after. Works great for weekdays. Won't be much fun for the weekends tho:)

77877f762c40637911396daa19b53094

(78467)

on July 08, 2011
at 01:53 AM

Just wanted to add that I have been someone who usually stays up past midnight every night and up wakes early, so my insomnia and wakefulness were starting to cause real problems. I'm thrilled to be able to affect my sleep so strongly by this one little thing.

0
Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 07, 2011
at 03:06 PM

It can take quite a while. I'm going to write about this issue this week. Seems this summer I have seen and unusual amour of adrenal fatigue and I'm not sure why this year is different. I will lay out all things I do in the clinic for this issue

667f6c030b0245d71d8ef50c72b097dc

(15976)

on July 07, 2011
at 03:08 PM

not an answer. completely not helpful. no one cares if you are "going to write about this issue this week." Answer here is answers, not allusions to your blog.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 07, 2011
at 03:34 PM

It's too long to put here. So I will do what I think is best to answer this. If he chooses to avoid it like you that is your choice. Most people like advice for free. Clearly some like you don't. I respect that.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 07, 2011
at 03:42 PM

Plus I'm in surgery between cases.........I don't have the time to give a full and complete answer. His question was about time and adrenal fatigue can take mons to get better based upon severity

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