It's Not You, It's Your Adrenals

I have a confession: It wasn’t long ago that I was addicted to all the things that I preach against – sugar, adrenaline, caffeine, dairy and alcohol. At Harvard Medical School, I was taught (and blithely internalized) the message that the ruthless and dogged pursuit of medical knowledge was noble, even if it meant denying basic needs. I gladly worked 120 hours per week for many years. I denied sleep, food, going to the bathroom and exercise. I delivered a thousand babies. I removed ovaries with minimally invasive surgery. I performed 500 hysterectomies. I saw 30 patients per day in the office for ten years.

How did that really make me feel?

Burned out. My adrenal glands could not keep up with the demand. I was a classic case of adrenal fatigue.

I was taught to minimize what I now believe to be essential and nonnegotiable: regular sleep; access to organic, whole foods, mindfully eaten; contemplative practice; loving connection and movement.

I pushed for years, running on adrenaline and fumes, until I crashed.


Adrenal fatigue is the most common hormonal imbalance in women. Find out if you have the classic, Harvard-approved symptoms and what to do about them.

My prior ways landed me in a massive mess at age 33—post-partum depression, excessive weight gain, unstable blood sugar, heavy latte habit—and fortunately, my path to finding my way out of my mess became my message. The root cause of my troubles? I burned out my adrenal glands, the pretty little pearls that sit on top of the kidneys, and produce the main hormones of stress: cortisol and DHEA. I produced too much of these hormones, probably for years. What does adrenal fatigue feel like? You feel tired but wired. You crave sugar, similar to an addict. You grow a muffintop.

Do you want the Harvard-approved, complete list of symptoms?

  • Anxiety, especially in stressful situations
  • Moodiness
  • Emotional instability or excessive emotions
  • Frequent screaming or yelling
  • Confusion, difficulty with focus, under stress
  • Poor resilience to stress – stress feels too much or unfair
  • Excessive sensitivity to human suffering
  • Irritability
  • Negativisim
  • Feeling of victimhood
  • Accusatory (more common in men) or quarrelsome
  • Sharp, verbal retorts
  • Energy: fatigue, especially under stress
  • Skin: inflamed such as with rashes, eczema or psoriasis
  • Autoimmune: predisposed to Hashimoto’s or connective tissue disease
  • Food: sugar cravings, intense hunger, salty food cravings

Later, after your adrenals have worked overtime for too long, they stop making the stress hormones. The adrenal glands burn out, and you feel depleted. Maybe depressed—not severely depressed—more low-grade sadness and don’t-want-to-get-out-of-bed-ness. As if you couldn’t handle another ounce of stress. You want to stay home every weekend and watch Apple TV. You want to cocoon.

Adrenal Fatigue is the most common hormonal imbalance in women.

My husband reports my daily return from my traditional gynecology practice in this way: “You’d come home and smile wanly – pour yourself a glass of wine and head upstairs to take a hot bath before you could really deal with being with the kids. After the bath, you’d have another glass of wine while you made dinner. We’d eat late, put the kids to bed, and you’d fall asleep the second your head hit the pillow. You’d wake up angry about drinking too much wine, and not happy facing another day of 30 patients.”

Shortly after that pretty picture in 2006, I broke free of traditional medicine to start my own integrative medicine practice for women. I reduced my hours from 12 hours per day to 6. I took my kids to school and picked them up, every day. I exercise four days per week. I got help so that I could eat and serve amazing, organic food to my family and myself. I slowly healed myself and climbed out of the hole I had dug for myself.

Still, sometimes I slip. Last week, a friend, who happens to be a massage therapist, was giving me a massage.

“Your superficial muscles feel fine. Normal. But when I work deeper, I feel that your intrinsic muscles, the stabilizers, such as your erector spinae, are extremely tight.”

That felt about right. On the surface, I’ve learned to look like I have my act together. But sometimes, internally, I am not aligned with my message. When that happens, I’ve learned to intervene far earlier, way before the crash. And I’ve learned how to teach this to others in my practice: to one woman at a time, or to a larger, cohesive group online.

I often saw women in my medical practice who were in a similar mess. They hum along with the job and kids and husband and sick mother and dog, and feel like they’re barely keeping it together. They use drugs, such as caffeine, sugar and alcohol to amp up energy and mood. Yet these forms of fake energy do not ultimately serve them. They are tired. They don’t want to have sex. They don’t feel authentically happy. They want to live life fully, but most of the time, they feel too overwhelmed. Often it’s premenopause or perimenopause that creates the perfect storm: put taxed adrenal glands together with sputtering ovaries, waning androgens and thyroid function, and many women (myself included) fall to their knees.

Women typically make 3 mistakes when it comes to their adrenal function:

  • They minimize their symptoms of approaching burnout, until they drop from overgiving
  • They reach for fake energy in the form of caffeine, sugar and alcohol
  • They soldier on in the face of overdrive, not realizing how out of alignment one or more aspects of their lives are with their beliefs

I have a simple 3-step solution.

First, start by attuning to your symptoms. Decode the messages your body is trying to send you. Listen for the health expressions that you have today, this week, this past month. Write them down in your new health journal.

Second, remove toxins, and replace them with good choices. Read my New York Times bestselling book, The Hormone Reset Detox. You’ll jump start your hormonal balance. You’ll stabilize your blood sugar and remove the fake energy (caffeine, sugar, alcohol, dairy, gluten). You’ll feel like you’re on a honeymoon – the Body Honeymoon.

, download my free guide below, “Dr. Sara’s 7 Proven Game Changers For Adrenals.”


To your robust adrenal health,



  1. Kathleen Bell on September 3, 2011 at 9:32 pm

    Great website and weekly newsletter! Thank you.
    Now I just need to get some supplements. Will someone be in the office after Monday?

  2. Sharon Braun on December 15, 2011 at 11:45 pm

    I’m so touched by your honesty and willingness to teach others what you have learned as well as IMPRESSED by your decision to change your situation. You inspire.

  3. Tonia on April 24, 2012 at 1:22 pm

    Now, 6 months later, I’m curious how coffee, butter, and the bulletproof, paleo life style fits into your thinking.

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