How To Train If You’re Dealing with Stress, Cortisol, or Adrenal Issues

By Dr. Brooke Kalanick

“Just listen to your body!”

We say it (and hear it!) all the time, but how do you actually do that? How do you listen to your body?

Teaching women how to listen to what their own hormones are saying is at the heart of the work I do. If we can start listening, this is how we will stop fighting ourselves, pushing beyond our limits and getting into hot water with our health.

Working with many, many women over the past dozen years, something I see over and over (and it’s a big problem) is women who are depleted, exhausted, and stressed, who continue pushing themselves further into hormonal disarray.

I’ve previously discussed modifying your nutrition, particularly your carb intake, based on the hormonal clues you receive via your appetite, cravings, energy, and sleep (my acronym, ACES). In this article, my goal is to show you how to heed these hormonal messages and listen to your body when it comes to exercise.

What is adrenal fatigue?

First, it’s important to distinguish between adrenal fatigue, and true adrenal insufficiency which is an autoimmune condition called Addison’s Disease. In a person with Addison’s Disease, the adrenal glands are under attack by antibodies, much like the antibody attack on the thyroid in Hashimoto’s. Someone who has Addison’s Disease will ultimately have low cortisol and often need to use cortisol replacement therapy. This is perhaps true “adrenal fatigue,” and it’s not the functional problem we’ll be looking at in this post.

As a functional problem, Adrenal Fatigue is better described as HPA (hypothalamus-pituitary-adrenal axis) dysfunction, or a discoordination between the messages the brain sends to the adrenal glands.

Adrenal fatigue is a bit of a misnomer. It’s not exactly that the gland is “too tired” to do its job as the term “fatigue” implies.

Rather, a person has lost their physiological ability to adapt to and cope with stress. It becomes harder to keep cortisol output on its normal circadian timing, which can result in periods of high or low cortisol overall, or inappropriately high or low at one point or another during the day (i.e. high at night when it should be low so you can go to sleep easily, or low in the morning when it should be high to wake you up.)

The effects of these stress hormone issues are there, yet many women don’t make the connection. A woman with cortisol issues is likely feeling and thinking something like, “Wow, I’m handling life pretty poorly right now!” Meanwhile...

Her sleep quality may have changed for the worse. Her period and PMS symptoms are more gnarly or less predictable. Her skin may be breaking out. Her digestion is off-kilter. Plus, she’s either wired or tired (or both!) most of the day, and always at the most inopportune times (i.e. tired but wired at bedtime, dragging in the morning or afternoon, etc.).

Although testing is the best way to determine exactly what’s going on with these hormones, the following overview of the main symptoms of high and low cortisol will give you a lot of insight:

Symptoms of High Cortisol

  • Can’t fall asleep at night, feel tired but wired at bedtime
  • Puffy look, all over but can usually be seen in the face
  • Wake achy and stiff, with a low appetite in general or cravings for carbs
  • Intolerance to exercise, difficulty recovering from workouts and healing from injuries
  • Difficulty losing body fat, particularly around the middle
  • Cravings for sugary/starchy and fatty foods

Symptoms of Low Cortisol

  • Irritability, lightheadedness, low energy, forgetfulness, shaking, etc. between meals, or as time for next meal approaches; feel like a different person after getting some food
  • Sugar or caffeine cravings, often between meals
  • Difficulty sleeping through the night
  • Low blood pressure (below 120/80) and sensitivity to bright lights and sunlight
  • Digestive issues including IBS like symptoms of alternating constipation and looser stools
  • Sluggish fat loss from “fat loss” exercises such as metabolic training, sprints, met con, etc.
  • Difficulty recovering from exercise, low tolerance particularly to intense exercise

These symptoms could be signs that your stress mechanism is losing its ability to function as robustly and coordinated as it did when you were younger. Who can remember staying up for days on ends during college finals, then sleeping in for a few days and waking up as good as new?

exhausted-mom-holding-baby-450x300Fast forward to having a newborn baby in your thirties, and feeling like you never recovered from the sleep deficit. Or, feeling achy and exhausted and getting lackluster results following an aggressive training program that ten years prior helped you lose weight and body fat easily. Or perhaps merely feeling like you have a low fuse for any type of stress as time goes on.

These are just a few examples of stress coping ability going downhill.

Most of the talk on healing the adrenals and working with adrenal fatigue centers around reducing stress. That’s all fine and good, and you should definitely be doing that. But but how do you work out during this healing phase? Can you work out, or are you supposed to just sit on the couch until you’re better?

All of this is a stress in and of itself—emotionally and physiologically—so my answer is no, you don’t just sit around and wait to get better. Yet, at the same time, it’s unwise to push a system that has lost the ability to cope with stress (exercise is indeed a stress). So what to do?

How to Manage Exercise While Healing Your Stress Mechanism

If you are experiencing low cortisol, your biggest risk with exercise is over-training. It’s best to avoid metabolic conditioning, HIIT, sprints, and intense metabolic training. Basically, anything that relies on a good cortisol and adrenaline output to complete and deliver results. You just don’t have it right now, so you won’t get the same results, and you will not give your system time to heal.

fatshaming-women-walking-450x338Definitely walk. Walk, walk, walk. Walking helps normalize the cortisol response, so it’s great whether your cortisol is high or low. If your cortisol is low, you can continue strength training, just don’t do any metabolic work. Your workouts should be more along the lines of traditional strength training with plenty of rest, big lifts (like squats, bench press, deadlifts, rows, and overhead presses), full body movements, heavy but low intensity and volume (i.e., a 5x5 or 3x6 protocol).

If you’re dealing with high cortisol issues you may want to tone down your metabolic training to just one or two very short sessions per week and keep up the walking. For both, high or low cortisol troubles, watch out with hour-long metabolic classes such as spinning, as well as many CrossFit and bootcamp classes. My advice is to avoid those entirely with low cortisol (you aren’t getting the benefits anyway). With high cortisol, you’ll do much better with shorter metabolic sessions, keeping them to to once or twice per week so that you don’t continue to drive the high cortisol output you’re dealing with.

For those of you with high cortisol, most definitely keep lifting. High cortisol can quickly erode muscle mass. It’s best to focus on using heavier weight with more rest for your strength training sessions, and reduce the overall intensity you feel during each session.

Also, be mindful of doing too much long, moderate intensity cardio. Cardio is not the devil. It has its place, but because it drives up cortisol without triggering any fat burning hormones like growth hormone (the way more intense training does) you’re increasing stress without getting the same fat burning benefits. It’s inefficient at best, and when your stress hormones are running high, you’re adding fuel to the fire.

For those of you who love those long runs or bike rides, don’t worry, you won’t have to avoid them forever. Get your stress response normalized, then find a way to keep those exercises you love in your life in a healthy way that works for you and with you. The problem is that not stopping certain activities that drive up cortisol, for at least a period of time, simply won’t give your brain and adrenals a chance to start communicating more effectively. If you can take a break from handling multiple sources of stress, you’ll be able to fit them in again in a more balanced way in the future.

Just give yourself a chance to heal.

Training earlier in the day can help, especially if you feel wound up at night and have a hard time falling asleep.

With both cortisol issues, make lots of time for recovery: rest days, rehab work, walking, gentle yoga, meditation, etc. Hone your stress management skills, and be careful if exercise is your go-to stress reliever (it certainly is mine!). When you feel that urge to go train again, try going for a walk instead.

Also, with both cortisol issues it’s important to prioritize sleep and do your best to resolve your sleep problems. You may want to take a peek at this article as well, if you feel you’ve managed stress well but still aren’t recovering. There are so many stresses we don’t even realize we have.

How to Monitor Your Cortisol Recovery

As you monitor your cortisol recovery there are some tools (that you already have!) that will help guide you. All you have to do is listen. Your own hormones will talk. Remember ACES: Appetite, cravings, energy and sleep.

Appetite: Appetite can be low with low cortisol and low or high with high cortisol. Pay attention and notice when your appetite starts to become more normal.

Cravings:When cortisol is low, cravings are often for sugar and stimulants. Notice when your desire for these starts to feel more under control. Cravings with high cortisol usually lean toward starchy, sugary, and fatty foods (pastries, fried foods, ice cream, chips, etc.). Note when those types of food start to feel less tempting.

Energy: Your energy should be more level, with fewer periods of highs and lows and less slumps in the morning or evening, and less of that “all wound up” feeling come bed time. Energy should also not drastically change when you eat. If you come alive after eating, that is often a sign of low blood sugar and low cortisol problem. Because high cortisol so often occurs with insulin issues, it’s important to watch for that post meal coma as well.

Sleep: As cortisol comes back into balance and you correct the discoordinated rhythm and timing of the brain-adrenal axis, you should also experience less trouble falling and staying asleep.

It can take time to understand and heed the messages your hormones are sending you, but when you don’t you become our own worst enemy.

We all need to stop battling ourselves and get on our own side, but in particular, those of us with hormonal challenges like PCOS and Hashimoto’s and those of us dealing with adrenal issues. You will feel the effects even more significantly if you don’t. All of these conditions can make weight loss, good energy, and even good health seem elusive.

Paying special attention to work with these unique issues instead of against them will not only get you better results, it will stop you from pushing your system into further disarray.

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About the author:  Dr. Brooke Kalanick

Dr. Brooke Kalanick earned her Doctorate in Naturopathic Medicine from Bastyr University. Known as “The Hormone Whisperer,” Brooke's balanced approach to health, using both conventional and alternative therapies, allows her to successfully treat patients with Hashimoto’s Hypothyroidism and PCOS as well as other female hormone imbalances. Learn more about Dr. Brooke on her website and connect with her on Facebook and Twitter.

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