Should You Follow A Ketogenic Diet If You Have Adrenal Fatigue?

Mark Volmer
Nov 9, 2018 · 7 min read

High fat low carbohydrate, or, ketogenic diets are becoming increasingly popular. But should those with adrenal fatigue jump on the keto bandwagon?

For any of you paying attention to the media, 2017 and 2018 are the years of the ketogenic diet. Supporters claim that a ketogenic diet can help you:

  • loose weight;
  • balance blood sugar and insulin;
  • avoid hunger cravings;
  • increase your energy levels and ability to concentrate and focus

Sounds like the perfect diet, doesn’t it?

But before you dive into the keto universe, know that the ketogenic diet is not a cure-all. And for those dealing with adrenal fatigue, the ketogenic diet may do more harm than good.

What is a ketogenic diet?

The majority of humans use sugar (glucose) as fuel. That means that foods (generally, carbohydrates) are broken down into glucose which your body then uses for energy production. But humans have the ability to burn a different source for fuel — ketones. Ketones are also known as “ketone bodies”. Ketones are byproducts of the body breaking down fat for energy that occurs when carbohydrate intake is low.

When your body doesn’t have a sufficient level of available glucose — which is what the body uses for its main source of fuel — and glycogen levels are depleted, blood sugar and insulin are lowered and the body looks for an alternative source of fuel. In this case, it uses fat. When this happens, you enter what is called ketosis.

Ketosis can happen when a person fasts, after prolonged exercise, during starvation, or when eating a low-carb/ketogenic diet. People following a ketogenic diet specifically reduce their carbohydrate intake for this reason — to force their body to utilize fat for energy. For a deeper dive into the ketogenic diet, check out this post.

Adrenal fatigue and ketosis

Adrenal fatigue occurs in response to a prolonged or intense stress. But remember, adrenal fatigue is not a real medical condition. If you want your medical doctor on board, refer to adrenal fatigue as hypothalamic pituitary adrenal (HPA) axis disfunction. HPA axis disfunction is the correct terminology for adrenal fatigue. But since the condition is colloquially known as adrenal fatigue, I will refer to it as such in this post.

In response to stress, your body will elevate cortisol levels. Should your cortisol levels remain elevated for an extended period of time, your brain will instruct your adrenal glands to decrease cortisol production. This results in the condition known as hypothalamic-pituitary-adrenal axis dysfunction/hypocortisolism, or adrenal fatigue.

Research suggests that there are 4 main causes of adrenal fatigue. These include:

  1. Chronic inflammation
  2. Blood sugar imbalance
  3. Sleep imbalances (circadian disruption)
  4. Stress

I’ve written at length on each of the 4 causes of adrenal fatigue. Please click the above links to learn more about each specific cause.

Since adrenal fatigue is caused by prolonged stress, it should be obvious that any diet or nutrition plan that causes an increase in stress levels is not recommended. If the thought of changing your diet to that of ketogenic variety triggers a stress response, you’re probably best to avoid dramatic dietary changes for now.

With that said, there are specific situations where those suffering from adrenal fatigue will benefit greatly from a ketogenic diet.

The adrenal fatigue diet

The most important step in an adrenal fatigue diet is to ensure you are eating whole foods. If your food rots, it’s a whole food. If your food can sit on your shelf for months, it’s (likely) not a whole food.

Whole foods aside, I also recommend the following dietary suggestions for those with adrenal fatigue:

  1. Eat adequate protein
  • It is absolutely essential you start your day with a protein source.
  • Avoid high levels of carbohydrates first thing in the morning (yes, that means giving up your muffin/bagel).
  1. Eat frequently during the day
  • Those with adrenal fatigue generally do better eating small meals/snacks frequently throughout the day.
  1. Avoid excess potassium intake
  • Have you ever got dizzy after standing? This is a common occurrence in adrenal fatigue. Avoid foods high in potassium to better balance your blood pressure.
  • Bananas, figs, raisins, and potatoes may be better avoided.
  1. Add some salt to your diet
  • Extra salt can help keep your blood pressure up.
  1. Consume modest amounts of caffeine
  • No more than 1 cup of coffee each day.

These are the very generalized principles you should follow if you have adrenal fatigue. The key word here is generalized. These recommendations don’t take your unique circumstances into effect.

The ketogenic diet could be the best diet for adrenal fatigue. But only in certain cases.

Should you go keto if you have adrenal fatigue?

Well, that depends. Some of you should absolutely go keto. It will make a dramatic difference in your energy levels. For others, the keto diet may bring about even higher levels of fatigue.

In practice, I find that those whose adrenal fatigue is brought on by blood sugar imbalances tend to do the best on a ketogenic diet.

How do you know your blood sugar is the cause of your fatigue?

You’re going to have to test it. You can purchase a glucometer from your neighborhood pharmacy. These can be purchased without a prescription.

Next, you’re going to want to start tracking something called your fasting blood sugar. Take this reading shortly after you wake up. If possible, try to go twelve hours without eating. For example, if you have dinner at 19:00 on Thursday evening, check your blood sugar at 07:00 Friday morning.

Your fasting readings should be between 4.0–5.0 mmol/L. If your reading is less than 4.3 mmol/L, you’re trending towards low blood sugar. If your reading is more than 4.7 mmol/L, you’re trending towards high blood sugar.

If you don’t have access to a glucometer, the below symptoms can help guide you in determining whether (or not) you have a blood sugar imbalance.

Symptoms of high blood sugar (1, 2):

  • Fatigue
  • Excessive urination
  • Increased thirst
  • Difficulties concentrating
  • Headaches
  • Blurred vision

Symptoms of low blood sugar (3):

  • Shaking
  • Nausea
  • Lightheaded
  • Irritability
  • Anxiety
  • Hunger
  • Weakness, drowsiness, and/or fatigue

Both high and low blood sugars are huge stressors. Should either continue for an extended period of time, the development of adrenal fatigue is probable. If your blood sugar readings are out of range, a keto diet may be the perfect solution.

How does a keto diet help adrenal fatigue?

When your body metabolizes carbohydrates, they become glucose (sugar). When you eat carbs, your blood sugar is going to be raised. There’s no way around that phenomenon. And in healthy individuals, it’s really not a problem. But in those with adrenal fatigue and/or blood sugar irregularities, carbs can be problematic.

Insulin and cortisol are the yin and yang of your blood sugar. Insulin helps to lower your blood sugar. Cortisol helps to raise it. In a perfect world, insulin and cortisol levels maintain some semblance of balance. But in adrenal fatigue, cortisol can drop to very low levels.

If your body is struggling to produce cortisol (like in adrenal fatigue), you’re going to be challenged in regulating your blood sugar. Especially when you eat carbohydrates. Here’s why:

After eating carbs, your blood sugar rises. In response to elevated blood sugar, your body releases insulin. Insulin moves the sugar from your blood and into your cells — thus, lowering blood sugar. But sometimes too much insulin gets released. This is called post-prandial hypoglycemia.

When this occurs, the excess insulin drops your blood sugar to uncomfortably low levels. You’ll experience a lot of the low blood sugar symptoms I listed above. To rectify the situation, your body calls on cortisol. Cortisol pulls the glucose molecules out of your cells and back into your blood. This raises your blood sugar and alleviates the symptoms of low blood sugar.

But what happens when you have low cortisol levels like in adrenal fatigue?

In this situation, your body doesn’t have the cortisol necessary to raise your blood sugar. So, your symptoms remain. This perpetuates adrenal fatigue. It becomes a vicious cycle — blood sugar irregularities cause low cortisol and low cortisol causes blood sugar irregularities.

Enter the keto diet.

When in ketosis, your body no longer relies on glucose (sugar) for energy. Instead, it relies on ketones (which are created by the metabolism of fatty acids). This has an incredibly stabilizing effect on your blood sugar. It’s the perfect diet to break the blood sugar cycle. This is how ketogenic diets help adrenal fatigue.

Who shouldn’t try the ketogenic diet?

It’s not that ketogenic diets are inherently dangerous, they just may not be effective for certain conditions (those with type I or II diabetes will need to work with a knowledgeable healthcare professional while implementing a keto diet). Before jumping headfirst into a keto diet, try to uncover the cause of your adrenal fatigue.

If your main stressors are coming by way of sleep issues (I’m looking at your shift workers) or lifestyle stress (think relationships, finances, family, work, etc) the ketogenic diet will not cure your adrenal fatigue.

In all likelihood, trying to implement a ketogenic diet when you’re dealing with sleep disturbances and/or high levels of stress at work will backfire. The extreme dietary changes involved with the keto diet will only add to your stress. This will often make your fatigue levels worse.

Even if you are dealing with inflammation and/or blood sugar issues, the proper implementation of the ketogenic diet is in itself a stress. Do your best to get a friend or your family on board. Having a support system is essential to your long-term success.

And, perhaps most important, take your time. If you’re eating a Standard American Diet, don’t try to go keto next week. Start with a fatigue reset diet. Start adding whole foods to your diet. Once you have a solid foundation, then look at implementing a keto diet.

The keto diet can be an incredible solution for certain types of adrenal fatigue. But it can make other types of adrenal fatigue worse. Go slowly. Listen to your body.

Remember, you’ll respond differently to the keto diet than your friend. Just because her fatigued improved does not mean yours will. If your adrenal fatigue worsens while on a keto diet, transition back to a whole food or fatigue reset diet.

The ketogenic diet is not a panacea for adrenal fatigue. But it may just be a successful means of treatment for you.

Learn more than your doctor about the foods that cause fatigue.


Originally published at Fatigue to Flourish.

Mark Volmer

Written by

I help those with fatigue naturally reclaim their energy and share their gifts with the world.

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