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What is the best diet for Adrenal Fatigue?  This question comes up a lot because there are so many types of diets from paleo to keto to low-calorie and autoimmune diet.  It can be confusing because there is so much conflicting advice and there are different types of diets for weight loss, autoimmune conditions and gut issues and since many patients with adrenal fatigue are dealing with all of the above deciding which type of diet to follow can seem overwhelming. 

Clinical studies have now shown that adrenal dysfunction can actually be improved using a carb-cycling strategy.  With adrenal fatigue, the cortisol rhythm is out of balance and levels can be too high or too low throughout the day.  No matter what stage of adrenal fatigue you have, the cortisol rhythm can be returned to normal, healthy levels by altering the type and amount of carbs eaten at specific times of day.  One of the roles of cortisol is to keep blood sugar stable by raising blood sugar levels when they drop too low.  Carbohydrates elevate blood sugar more than protein and fat. When blood sugar is up, cortisol goes down, therefore higher carbs push cortisol down.  So it makes sense that at times of the day when we want to lower cortisol we should eat higher carbs and when we want to raise cortisol our meal should be lower carb.

The graph below shows what a normal cortisol rhythm looks like: levels are highest in the morning around 8am and gradually decrease throughout the day with levels lowest at night.

To support peak cortisol in the morning, breakfast should be low carb and high protein.  At noon a moderate amount of carbs is beneficial and in the evening, a higher carb meal is best to support the appropriate shutdown of cortisol to allow for deep, restorative sleep.

Keep in mind that not only is the amount of carbs important for balancing cortisol but the type of carbs is equally as important.  The type of carbs we are referring to is the complex kind.  Complex carbs refers to high fiber foods like brown rice, steel cut oats, quinoa, beans, lentils, squash, fruit and potatoes.  As a general rule, simple carbs (refined grains, processed foods, white flour products, sugar) should be avoided with any healthy diet.  Simple carbs cause sudden spikes and drops in blood sugar which can make adrenal fatigue worse.

Here’s how to structure your meals to balance cortisol levels:


Highest protein/Lowest carb meal

Example: Protein smoothie (protein powder with frozen strawberries, spinach and almond milk)


Moderate carbs and protein

Example: salad with grilled chicken


fruit with nuts

carrot sticks with hummus


Highest carb meal

Example: veggie and chicken stir-fry with brown rice

One clinical study examining the effects of carb cycling on women with cortisol imbalance showed that within 1 month of dietary changes cortisol levels improved by 50% and the women also experienced a decrease in body fat.  In another study, the effects of high fat/low carb diet vs moderate fat/moderate carb diet on cortisol metabolism in obese men showed that a lower carb diet was able to regenerate cortisol by increasing the enzyme (11beta-HSD1) that activates cortisol and reducing the enzymes (5-alpha and 5-beta reductase) that inactivate cortisol.  Other improvements seen in the lower carb group were greater weight loss and improvements in glucose and insulin levels.  The regeneration of cortisol in the low carb group was independent of the difference in caloric intake between the low carb and higher carb group meaning that the amount of calories consumed was not a factor in the positive changes seen, rather it was the ratio of carbs in the diet that made the difference.

Cycling complex carbs not only helps re-establish a normal healthy cortisol rhythm but also helps with weight loss, improves sleep and balances blood sugar and insulin.