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Can Keto Cause Adrenal Fatigue?

Louise | June 10

You might have read that low carb diets (like keto) can cause adrenal fatigue.

A quick search on Reddit or Google will show you dozens of different opinions and it can be hard to separate the facts from the fiction. Not to mention that it’s tricky to look through the scientific evidence and make sense of it all.

That’s why we’ve tracked down the opinions of knowledgeable experts and put them together for you to check out what they’ve got to say…

This article will explain what adrenal fatigue is and will give you the truth about whether or not the Keto Diet can cause it (according to experts).

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What’s a Keto Diet?

The short answer: It’s a diet that puts your body into nutritional ketosis by limiting carb intake.

What’s nutritional ketosis?

It’s a metabolic state where your body uses ketones (which come from fat) as an energy source, instead of depending on glucose from carbohydrates.

Ketones are made in your liver by breaking down the fatty acids from your fat cells. They enter your bloodstream and are used as a source of energy by your body.

So in nutritional ketosis, your body is burning your stored fat as fuel.

Bottom Line:

The Keto diet puts you in nutritional ketosis, which simply means your body is burning your fat for energy.

How does limiting carbs lead to ketosis?

Your body’s default is to use glucose as an energy source. Ketones are produced if there’s no glucose available.

There are a number of situations where this may occur but here we’ll focus on two of them:

  • If you’re consuming a low carb diet (aka keto or similar)
  • If you’re fasting (even overnight can be enough)

Because you run out of stored glucose (glycogen), your body is forced to break down your fat stores to create energy, which in turn leads to the production of ketones.

Can Keto Cause Adrenal Fatigue?

What do you eat on a keto diet?

You eat lots of fat, a moderate amount of protein, and under 25g of carbs per day.

  • Lots of leafy green vegetables
  • Healthy fats like ghee, coconut oil and olive oil
  • Plenty of meats, organ meats and seafood
  • Moderate amounts of nuts and seeds

And the foods you avoid are:

  • Sugar in all its forms (including honey, agave and corn syrup)
  • Any kinds of grains (wheat, rye, cornmeal etc) or grain products (most flours)
  • Processed foods (crackers, chips and most things from a package/box)
  • Most fruits, as they’re simply too high in sugar despite the nutrients they contain

Bottom Line:

On the Keto diet you eat lots of fat, a moderate amount of proteins, and under 25g of carbs per day. You avoid grains, most fruit, sugars, and processed foods.

Why is a Keto diet good for you?

Lots of reasons! Here are just a few…

  • It helps with weight loss (1)
  • It lowers high blood pressure (2)
  • It stabilizes blood sugar levels (3)
  • It reduces your risk of heart disease (4)
  • It increases your mental clarity (5)
  • It boosts your energy levels (6)

What’s Adrenal Fatigue?

Nowadays, health practitioners are more likely to label this, “HPA axis dysfunction”.

What’s your HPA Axis?

Your HPA axis is your body’s stress management system and it’s made up of 3 distinct parts of the body that work together:

They are:

  • Hypothalamus (a region in your brain)
  • Pituitary gland (also in your brain)
  • Adrenal glands (just above your kidneys)

An intricate balance of coordinated hormone production by this trio allows your body to react to and deal with stress of all kinds.

What causes your HPA axis to malfunction?

Two words: chronic stress.

Whether your body is under stress for physical reasons, such as illness or allergies, or psychological reasons like relationships or work, constant stress leads to a constantly stimulated HPA axis.

After a while, if the stress does not resolve, your HPA axis may start overreacting or underreacting. This has the downstream effect of causing problems for the rest of your body.

Can Keto Cause Adrenal Fatigue?

What are the symptoms of HPA axis dysfunction?

The most common signs are:

  • A persistent feeling of fatigue (this is the main one)
  • Depression and anxiety
  • Difficulty concentrating and remembering things
  • Insomnia and disturbed sleeping patterns
  • Muscle pain, joint pain and headaches

Bottom Line:

Adrenal fatigue (also known as HPA axis dysfunction) occurs because of chronic stress. The symptoms can be fatigue, depression, anxiety, insomnia, muscle pain, and more.

Expert Answers: Can the Keto Diet cause Adrenal Fatigue?

Dr. Tommy Wood

Summary: Tommy Wood took a close look at the data available, and found there’s no conclusive evidence that the Keto diet directly causes adrenal fatigue.

That’s because symptoms of adrenal fatigue often come down to eating too few calories:

“Much of the data used to support the idea that the ketogenic diet causes thyroid/adrenal issues come from studies where people are in a calorie deficit. If you’re on a ketogenic diet and eating enough calories, then this problem often goes away.”

And a change in cortisol levels doesn’t necessarily mean your adrenals are malfunctioning:

“Often we’ll see changes in cortisol levels because cortisol metabolism is improving as metabolic health improves, rather than because the diet is stressful or the adrenals become “fatigued” (which isn’t really a thing).”

Finally, although there is some research showing that the Keto diet has an effect on thyroid hormones, it may not be reliable:

“There is also some data suggesting that active thyroid hormone (T3) levels decrease on a ketogenic diet even in the absence of caloric restriction, but this occurs without a change in TSH. Therefore, the interpretation is that sensitivity to T3 has increased, which means you need less of it to have the same effect. This is certainly possible, but TSH is a very unreliable marker, especially in the presence of stress or inflammation.”

He has some simple advice for any Keto dieter who’s concerned about their adrenal health:

“If people are worried, their best bet is to make sure they eat enough total calories, and track their symptoms (i.e. mood, energy, and cognition), as well as their thyroid hormone levels and basic blood tests. Basal morning temperature is an easy thing to measure, and tends to drop in people with poor thyroid function. If you’re consistently colder in the morning whilst eating Keto, that’s a good sign that you might need to tweak the diet a bit.”

(Note: Quotes taken from email correspondence.)

Dr. Daniel Pompa

Summary: Dr. Pompa believes that Keto may even help heal adrenal fatigue…

“Here’s the thing. It may take longer for someone with adrenal fatigue to get into ketosis. However, they do. Then it becomes less of a stress. Once the cell, the mitochondria, becomes an efficient fat burner, there’s frankly less stress because you’re not getting the glucose rises and the glucose drops.” (7)

Can Keto Cause Adrenal Fatigue?

Dr. Anthony Gustin

Summary: Dr, Gustin firmly argues that Keto does not have negative effects on your adrenal function.

“Ketosis acts on the hypothalamus in a completely different way than a non-ketogenic diet, with no conclusive data regarding reduction in hormonal activity in the HPA axis.” (8)

Leanne Vogel

Summary: Leanne’s view is that a Keto diet won’t negatively affect your adrenal function – if you don’t have any existing problems with your adrenals. But if you’re already suffering from adrenal fatigue, then you may need to modify your Keto diet.

For the “high-fat Keto enthusiast” who also wants to heal their adrenals she recommends experimenting with increased carbohydrate intake:

“The first [thing] you could try is eating high fat, keto, low carbohydrate throughout the day and then pound the carbs every night […] I’m eating low carbohydrate, high fat, keto for breakfast and lunch […] Then dinner, I always have, every single night, I have some sort of starch. This is like sweet potatoes, plantains, cassava, white rice.” (9)

She also advises varying your diet to improve nutrition:

“Switch it up every week. Buy some new keto vegetables and different berries and low carbohydrate fruits that you can enjoy that round off the nutrients that you’re getting on a weekly basis.”

Luis Villasenor (Founder at Ketogains.com)

Summary: Luis told us that the symptoms which look like HPA axis dysfunction are usually just caused by taking in enough electrolytes. In other words, they’re simply related to good old Keto Flu!

And that means Luis has an easy fix:

“Once people adjust electrolyte intake when doing keto, the symptoms should subside (if people ever got them at all).”

If that doesn’t help you, Luis believes the cause could be your cortisol levels:

“Low carb diets, as well as fasting, mimic a starvation-like response on the body, without actually “starving” – low carb diets make the body think food scarcity is on the horizon, hence why the body taps into stored body fat more easily. This can cause cortisol to rise, as well as adrenaline to be elevated more than normal, and for some individuals, this can affect sleep patterns.”

And his advice for your next step is…

“Either ‘wait it out’ and let the body adapt, all the while monitoring electrolyte intake. Or increase carbs A BIT so the symptoms subside, especially around night time, to help with the release of tryptophan which may help induce sleep.”

(Note: Quotes taken from email correspondence.)

What’s the conclusion?

The general consensus seems to be the Keto diet doesn’t actually cause adrenal fatigue – unless you’re severely reducing your calorie intake over a long period of time (and that’s something which can happen with other diets too).

  • An important caveat: we’ve been focusing on whether the Keto causes adrenal fatigue. If you already have adrenal fatigue, you’ll need to think carefully about starting a Keto diet and proceed with caution, monitoring your health as you go.

Bottom Line:

The experts seem to have a general consensus that the Keto diet doesn’t cause adrenal fatigue (especially if you’re eating enough calories). If you already have adrenal fatigue, then you should be cautious about starting a Keto diet.

Tips for healing from Adrenal Fatigue

Reduce your stress levels

Far too much stress is what causes adrenal fatigue in the first place – so how can you expect to heal without reducing your stress levels?

Meditation is one of the most effective ways to do this, as it can help you feel calmer even if you’re in stressful circumstances.

But it’s not the only way: simple things like taking a 5 min break if your work gets stressful, getting out in nature, or minimizing the time you spend with negative people can also be helpful.

Can Keto Cause Adrenal Fatigue?

Stop exercising excessively

Overtraining is in fact another form of stress, but it’s physical stress rather than mental stress.

Not allowing your body time to recover properly between workouts can trigger your HPA axis, and it’s counterproductive to your health goals. Endurance athletes will find it decreases the amount of time they can train.

That’s not to say you should stop exercising completely, as more gentle activities like yoga and swimming are good ways to stay in shape while you recover (plus they can reduce stress, too). Just be careful to listen to your body!

Decrease your inflammation levels

When your stress response is constantly activated, the chemicals your body produces because of this lead to chronic inflammation – and this causes health problems (10).

Supplements like curcumin can be a good way to decrease inflammation (11).

And so can adding more inflammation-fighting foods to your diet, like salmon – which is rich in inflammation-fighting omega-3 fatty acids (12), and broccoli – which is full of antioxidants and anti-inflammatory compounds (13).

Get plenty of good quality sleep

Making sure you get enough high quality rest is vital for helping your body recover.

A few tips for improving sleep:

  • Reduce your stress levels (are you detecting a theme here?)
  • Avoid exposure to blue light before bed (aka no screen time!)
  • Use blackout curtains at night and make sure you’re exposed to bright light every morning
  • Keep your sleep cycles on track by getting up and going to sleep at the same time each day

Bottom Line:

Heal from adrenal fatigue by reducing your mental, emotional, and physical stress, decrease your inflammation, and get lots of quality sleep.

Feeling ready to try Keto?

Now that you know that Keto doesn’t cause adrenal fatigue, you can feel confident in getting started.

We’ve got plenty of useful resources to make things easier for you, like this Keto Diet Food List.

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