Generally, cortisol follows a natural healthy pattern of release that looks like this: It’s highest first thing in the morning, which allows you to get up, feel energized, and get going with your day. It remains elevated, gradually declining until the evening, which allows you to have the ability to respond and adapt to any perceived stressful event that crosses your path. By the early evening, cortisol levels should naturally be at their lowest point of the day. This is beneficial because cortisol is a stimulating hormone, so a decrease helps to prepare you for sleep. Plus, if you go to bed early enough, your body should not be producing any cortisol between the hours of 10 p.m. and 2 a.m. That four-hour window, therefore, is true physiological recuperation time. (As a side note, I always told my adrenal-compromised or stressed patients to try to be asleep by 10 p.m., since this is the time that matters most to recuperate from stress).

The good thing about short-term stress is that it comes, you deal with it and it goes. But the unrelenting stress that comes with worries about finances, a divorce, a job you despise, chronic illness or generally feeling overwhelmed with your life can cause lasting damage. Persistent or chronic stress involves a different physiological process in your body. Whether the stress is physical, emotional, mental, or environmental, real or imagined, your body releases high amounts of the hormone cortisol. Like adrenalin, cortisol is produced in the adrenal glands (the two glands that sit on top of your kidneys), sparked by a signal from your brain.

A variety of stressful conditions, such as feeling cold or hungry, low blood pressure, pain or broken bones, injuries, inflammation, intense exercise, or emotional upsets, cause the brain to activate our stress pathway. Our sleep-wake cycle does, too. Although it is only about the size of an almond, your mighty hypothalamus is the master integrator of your mind and body via the stress response pathway and its control over cortisol production. If you have a mood disorder such as anxiety, depression, post-traumatic stress disorder or exhaustion, or if you have a digestive issue such as irritable bowel syndrome, you can bet that your stress response pathway is in overdrive, cranking up your cortisol.

Making the effort to manage both your thinking patterns and your environment is vital to achieving hormonal balance. If you routinely have anxiety-provoking or upsetting thoughts racing through your mind, your stress systems will constantly be working overtime. A certain area of your brain also reacts to the stressful or upsetting circumstances in your environment. So, it pays to be mindful of what you allow yourself to be exposed to. Mental and emotional stress may be most injurious, because they’re usually not followed by a relaxation response the way most physical stress is. If the perceived stressful event remains constant in our mind, our body cannot fully achieve a relaxed, healthy, balanced state. When prolonged, this state of imbalance leads to permanent physiological changes.

Unlike adrenalin, which draws on your fat stores for energy during stressful situations, cortisol consumes your muscle tissue for fuel. Prolonged stress can, and usually does, lead to muscle wasting and high blood sugar as your body struggles simply to adapt. When these conditions take over, stress becomes extremely destructive to your metabolism, bones, muscles, and brain cells.

Now, let’s add your choice of workouts to this stress picture. Before we go on, let me be clear: exercise isn’t bad. The mental and emotional benefits of working out seem to be consistent across the board, no matter what type of exercise you choose. What is bad is the high-stress culture. And if you’re under a lot of mental or emotional stress, exercising can help because it impacts your cortisol. However, when your cortisol is high already, and you exercise in a way that makes it spike, it can become an issue. This is especially likely if you exercise when feeling exhausted at the end of the day; for very long periods of time; of if you choose very long high-intensity sessions or too-frequent workouts. When you are in an adrenal-stressed or fatigued state, the type of exercise you choose is critical—choosing the wrong activity will only perpetuate the problem.

Here’s a simple summary of the workouts you should not doingg this state (and even in a healthy state, for that matter, because of the effect on cortisol and lack of impact on muscle gain):

Spinning. Although the music is good for you, I used toplead with patients to quit their spinning addiction. The only way I think this cycle gig can be good is to limit it to 30 minutes and then leave the class. This will allow you to prevent the gradual increase in cortisol that can happen with a longer session. Moderate to high-intensity exercise,like running or spinning, provokes increases in circulating cortisol levels. By contrast, low-intensity exercise does not result in significant increases in cortisol levels; in fact, low-intensity exercise can result in a reduction in circulating cortisol levels, according to The Journal of Endocrinology Investigation (July 2008). If you love this style of workout, please try to use a scale at home that monitors muscle mass (your protein intake will help), and do not do it if you have an adrenal issue.

Orange Theory. You’ll lose fat, but you could eventually also lose muscle because of the spike in cortisol caused by the intense cardio included in the sessions. Completing cardio before strength training, or mixing the two activities in one session, is shown to increase cortisol, according to numerous studies that I have reviewed, including the latest one I’ve seen in the European Journal of Sport Science(April 2017). When you complete strength training on its own, or strength training followed by a short high-intensity cardio activity, cortisol is typically not increased. The amount of lactic acid was also higher in the group that did the endurance training first, which would compromise performance for the strength training component and hinder gains from the workouts. My suggestions for spinning also apply here. 

CrossFit. Maybe this should be called “CrazyFit.” You will lose fat, but most likely also overtrain, risk immune suppression and eventually risk getting hurt as shoulder and low back injuries are common in this sport, according to the Journal of Sport Rehabilitation (May 2018) and theOrthopedic Journal of Sports Medicine (April 2014). CrossFit practice is, however, associated with higher levels of a sense of community, satisfaction and motivation,according to Sports Medicine: Open (February 2018).

Boot camp classes should be cut. You probably won’t gain muscle; you may maintain or even gain fat from the stress of the workout, as it boosts cortisol and drops your thyroid hormone, or lose both muscle and fat due to cortisol. If love this style of workout then please, try to use a scale at home that monitors muscle mass (your protein intake will help) and do not do it if you have an adrenal issue.

Marathon running should be done only in your mind. Cortisol, cortisol, cortisol—cutting your muscle and immunity down! Frequently running more than 40 minutes is not helpful because of the adverse impact on your muscles and hormones. After an intense exercise session,cortisol levels are higher, thyroid hormones are lower and testosterone plummets. An August 2016 study in the European Journal of Applied Physiology compared pre–and post–endurance workout measurements of cortisol, testosterone and thyroid hormones. Researchers found it could take up to 24 hours for thyroid to return to baseline, 48 hours for cortisol and 72 hours for free testosterone. Think of the impact this has on your mood, muscle mass, memory and metabolism. Stop running long distances; instead, shorten your runs and go faster by sprinting. Running does damage to your muscle mass and, contrary to popular belief, it does not help maintain bone density.

Pilates could be passé. Many of my patients raved about Pilates and their core strength. But I never found one who wasn’t deficient in lean body mass after using bioimpedance analysis to assess their body composition. Don’t just take my 22 years of clinical experience for it; a study published in the Journal of Sports Medicine and Physical Fitness (November 2017) found similar results. Although Pilates is a popular activity among women, the empirical, quantitative evidence indicating a positive effect of Pilates exercises on body composition is still poor. This group tested the concept by having 37 women (aged between 40 and 50) complete 90 minutes of Pilates three times a week for eight weeks. They measured the women’s body composition with a bioimpedance analysis before and after the study. The results showed that weight, BMI, fat percentage and waist, abdomen and hip circumference decreased significantly after training, while no significant difference in lean body mass was observed. Guess what? Eight weeks of yoga, strength training or Nordic pole walking three times a week would offer you a completely different outcome—you would gain lean mass, and the research is there to prove it, right along with my clinical notes. 

I hope you are starting to see the point I am making. If any of the activities mentioned above describe your workouts, I hope you will reconsider doing the wrong things, or at least make time for things that are proven to help.

Let me clarify something else before we go on: it is possible to manage, and perhaps even negate, the harmful effects of these workouts—if you have the constant support of a trainer, integrated medical doctor or naturopathic doctor who can perfect your protein and nutrient intake, monitor your adrenal function, stay on top of your lean body mass and fat mass, and monitor your blood immune markers. Most of us do not have access to expertise like this, so no accommodations are made, and in the long run, the damage is done by these types of workouts. 

It’s all about cortisol control. 

Some tweaks are, however, possible. Recall that I mentioned your cortisol decreases as the day goes on, so it would be beneficial for your sleep, stress recuperation and healing if you chose to do more stimulating exercise in the morning, when cortisol is naturally higher.

Adrenal Gland Burnout

If you always feel tense or anxious, your body remains in a constant state of heightened arousal. Constantly overproducing cortisol and adrenalin day after day because of ongoing stress, multi-tasking, skipping meals, excessive calorie restriction, insufficient carbohydrate intake, overconsumption of protein, lack of sleep or too much coffee will lead to adrenal gland burnout.

In this state, your adrenal glands simply can’t keep up with the constant stimulation and outrageous demands for adrenalin and cortisol production, so they simply shut down. When your adrenal glands go on strike, cortisol and adrenaline levels plummet, which can result in many or all of the following symptoms:

• chronic fatigue or lethargy (difficulty getting up in the morning, even after sufficient hours of sleep)

• sleep difficulties

• difficulty concentrating or remembering (brain fog)

• depression

• weakened immunity or inflammation

• need for coffee or stimulants to get going in the morning

• feeling better suddenly for a brief period after a meal

• cravings for salty, fatty and high-protein foods such as chips, meat and cheese

• intolerance for exercise—you may feel worse rather than better after your workouts

• low blood pressure and blood sugar

• light-headedness (including dizziness and fainting) when rising from a sitting or lying-down position

A common clinical problem with underactive adrenal glands is hypoglycemia—or low blood sugar—especially between meals or while sleeping. When your body is healthy, it releases hormones, including cortisol, to liberate glucose to maintain the functions of our brain, organs and cells when blood sugar levels decline between meals or overnight during sleep. When cortisol is depleted, however, glucose levels tend to become too low. Ultimately, this causes light-headedness, shakiness and irritability typically associated with low blood sugar. It also explains why people with low blood sugar commonly wake up during the night. (If this describes your sleep pattern, your protein before bed will certainly help.)

The take-home message is clear: endurance exercise, if the sessions are too long, increases the amount of time your body is under physical stress, and combining strength training with endurance training, especially if the latter is completed first, is known to increase cortisol. But what if high-intensity exercise is your jam? If you have adrenal gland fatigue, you should not do any other types of exercise besides strength training (that is, exercise that does not involve balancing exercises or jumping, but focuses only on strengthening large muscle groups, to avoid placing more stress on your nervous system). Cardio of any kind should be avoided completely. Yoga is a must for its strength-restoring and hormone-recouping benefits—and can replace the weights, too, if that’s your preference.

Eventually, as your adrenal glands restore (as will be seen if you monitor symptoms, as well as through blood cortisol testing and orthostatic blood pressure testing—when you are healthy, your BP will increase when you move from a lying-down to a standing position), you won’t need to keep avoiding high-intensity exercise. To increase your recuperation quicker, a restoring adrenal gland supplement should be added like Cytozyme AD, which was the strongest and most effective supplement I found for the fatigue and weakness associated with adrenal exhaustion when I was in clinical practice. Each bottle has 180 tablets, so it provides a healthy supply, which is necessary because adrenal fatigue requires consistent treatment for a number of months. 

New Year No Adrenal Stress Workout  

Here’s a workout you can use that will not tax your adrenals or your nervous systems and it will work on restoring your strength, energy, and metabolism faster than if you started with cardio training. It’s full body circuit training that you can complete four times per week for a maximum of 30 minutes. Complete the exercises one after the other, with little rest in between. However, rest when you need to rest. Gradually work up to completing three rounds of the exercises, which should be modified based on your ability and injuries, should you have any. I have listed the weight I use for your reference. Watch videos on YouTube on how to properly complete the exercises if you aren’t sure of the form. Equipment needed: Dumbbells (5, 8, 10, 12, 15, and 20 or 25 pounds depending on your strength), bench and a stability ball 55 or 65 cm).

DAY 1: 

• Laying down triceps extension – 15 reps (2×10 lb)

• Laying down over the head straight arm lat pull – 1 dumbbell– 15 reps (1x 20 lb)

• Laying down double leg hamstring curls on the ball – 20 reps(focus on keeping your hips up even when your legs extendout on the top of the ball)

• Against the wall – bend knees to 90 degrees if you can or think ass to ankles – squats with back on the ball on the wall – feet hip width apart –15 reps (with ball on the wall I hold 1 x20 lb DB or hold 2 x 12 lb DB

• Dumbbell bent over rear delts – 15 reps (2 x 5 or 8 lb )

• Double arm bent over row – 15 rep – (2×15)

DAY 2: 

• Chest DB press on the ball with hip thrust up each time you lower your arms lower your hips and then thrust up hips as you press your arms up (2×15 lb) – 15 reps 

• Single leg backwards, sideways or front lunge with a single arm shoulder DB press when you bring your legs back to standing on the same side you are lunging with. (1×10 lb) – 12 rep each side

• Bent over read delt side raises (2x8lb) – 15 reps

• Single arm row on the bench (1 x20 lb) – 15 reps 

• Sumo dead lifts – feet wide apart toes pointed out – shoulder blades down and back – bend over when you come up thrust with hips – 15 reps (2 x 15 lb)

• Hip feet weight apart – partial squat with double arm row as you. Come up from the squat – you never stand up fully it is a small range of motion – 2×15 lb – 15 reps . Legs burn!!!