Raveling OAT Axis Imbalance:: Self-Treatment

treating your adrenals

A few days ago we discussed the intricacies of OAT Axis Imbalance which involves the ovaries (estrogen/progesterone connection), adrenals (insufficiency and fatigue), and thyroid (hypothyroid either primary or secondary).  As a professional, I cannot stress that if you suspect you have OAT Axis Imbalance, it is imperative that you see a professional, someone who knows how to interpret the symptoms and, in some cases, lab results, prescribe a multi-pronged approach with nutrition, lifestyle, and supplementation, when needed.  Feel free to contact me for a consultation on how to get you up and on the road to perfect health.

Though I don’t recommend trying to navigate the self-supplementation route, a few key lifestyle changes to calm adrenals will also have dramatic positive effects on taming the thyroid and harmonizing hormones.

1. Remove the root causes of chronic stress.  I realize this may sound like an impossible task, however, resolving marital, relationship or family issues, and dealing with financial problems head on will do more for your health than you ever thought possible.  I am not suggesting life will not throw you curve balls or that it isn’t stressful, however, instead of burying your head in the sand and avoiding financial crisis, or allowing your relationship issues to fester, coming up with a plan for dealing with them, therefore bringing you back into harmony with your environment is the number one and most important step in the road to recovery.

2. Make time for meditation and/or prayer.  When you think you have nobody to talk to and no one is on your side, prayer can help.  The power of having a relationship with your higher power is incredibly calming and centering.  Meditation teaches you that no matter what is going on in your life, calming the mind and stepping “outside” of the chatter in your mind can be incredibly healing.  I recommend the period 21-Day Meditation Challenges given by The Chopra Center if you are a beginner or a seasoned veteran.  The sense of community is as incredible as the guided meditations and mantras.

3. Sleep. Sleep is your body’s way of recharging and rejuvenating.  In fact, it is when most of the body’s detoxification takes place.   It is important to go to sleep by 10 p.m. every night. Am I crazy to say 10pm?  No and here’s why. If we are not asleep by10pm our adrenal glands are forced to kick in for a “second wind” to wind us up from 11 pm to 1 am. This puts tremendous strain on the adrenal glands. When we allow ourselves to sleep early, our adrenals are allowed to rest, rejuvenate and fully repair.  Ultimately it is between 10pm and 11pm that the body works at repairing the adrenals and the body must be in a state of rest for that to happen. We should also try to sleep in until 8:30 a.m. or 9: 00 a.m.when  possible. (I am sure you are rolling on the floor laughing at this point, but when you are healing from adrenal fatigue or worse, adrenal exhaustion getting help with the house or a little flex-time at work might be in order to get you the rest you need.)  Cortisol level rises to its peak from 6:00 a.m. to 8:00 a.m. in order to rev us up for the day ahead.  If we allow our bodies to naturally reach their peak cortisol levels we will be able to handle the stresses of the day a lot easier.

In later stage adrenal fatigue, the level of cortisol falls and we feel tired. It will be more difficult to wake up. If we were to wake up too early, this will only increase stress on the adrenal glands, which will have to produce more cortisol when it is already exhausted.

A good night sleep is mandatory for healing the adrenals.  This is not negotiable to fully recharge.  I understand completely that it’s not always possible to sleep in but whenever humanly possible, catching those extra ZZZs will do wonders for healing your body. Without good quality sleep, our bodies cannot regenerate and the ability to deal with stress the next day is impaired.

It should also be mentioned that between the hours of 8 and 8:30 pm, room lights should be dimmed to allow melatonin production to kick in properly and sleeping in a dark room will allow your body to stay asleep easier.  For women, sleeping with the light cycles of the moon (Lunaception) can help normalize menstrual cycles, decreasing the likelihood of luteal phase defects, and anovulatory cycles. (Cycles in which there is no ovulation.)

3. Avoid Coffee or Caffeinated Beverages. Coffee (even decaffeinated), tea (black and green), energy drinks and sodas act as stimulants and interrupt healthy sleep patterns. Herbal tea and tisanes are acceptable because they contain no caffeine.  I am not talking about only at night.  When you are healing from OAT Axis Imbalance, cutting your caffeine is key to avoiding stimulating an already confused adrenal system.

4. Avoid TV and Computers at night.   Watching Homeland might sound like a relaxing evening but it can prevent melatonin levels from rising in order to induce sleep. Some people are more photosensitive than others however, many sleep studies indicate turning off the TV and computer by 8pm will help you get a better night’s sleep. In our house, TV is off and computers are forbidden after 9pm (ah the compromise of marriage) and candles are lit, lights are turned off, and hushed tones are taken to welcome sleep.

5. Exercise. A leaner midsection is not the only benefit of exercise.  It is incredible for stress reduction and a fantastic way to oxygenate the body. Exercise reduces depression and anxiety, boosts blood flow, normalizes level of cortisol, insulin, blood glucose, growth hormones, thyroid, and gives you a sense of overall wellness.  Please bear in mind, running a marathon may not be for everyone.  Find an exercise that gets you excited to stick to it.  Some people may enjoy running, others may enjoy yoga and still others may enjoy walking.  I would urge you, as often as possible, to exercise outdoors to connect to the world around you.

6. Eating Pattern.  Most people are forced to wake up while cortisol levels are trying to peak between 6am and 8am.  Appetite during this time may be diminished not only because our bodies are busier trying to charge us up for the day rather than triggering hunger and we may feel too rushed to eat breakfast.  Most of my clients complain, when they first come to me, that I require breakfast be eaten, NO EXCEPTIONS.  Even if it is a smoothie with protein (protein is important), something must be eaten in the morning within an hour of rising.  Even though you may have no appetitite, the body’s need for an energy supply does not change during this period. Even a small snack is better than nothing at all and will provide the necessary energy requirement.  An example of how an optimal morning would go would be upon rising, a warm cup of water, ginger, and lemon. For women that are estrogen dominant, chewing on a carrot after this, a few carrot sticks or carrot salad will help detoxify excess estrogen.  Next a small protein snack or breakfast with protein and some fruit (i.e a fruit smoothie with nut butter, whey protein powder, or some SunWarrior Blend protein powder for those who need a vegetarian option) will have you charged up and ready to go in no time.

Skipping breakfast is NEVER a good idea. If your blood sugar is allowed to dip, the adrenals are tasked to secrete cortisol because cortisol activates gluconeogenesis to increase blood sugar level which allows the body to function. Therefore it is important to have a healthy breakfast soon after waking and no later than 10 a.m. This saves the body from having to play “catch-up” the rest of the day.


Glucose is a simple sugar found in food.  Glucose is THE essential nutrient that fuels the body in order for cells to function properly and the preferred fuel source by the body.  After meals, food is digested and broken down into glucose and other nutrients. The glucose is absorbed by the cells in the intestines and carried by the bloodstream to cells throughout the body. Glucose, however, needs to be helped into the cells by insulin.  Think of the cell receptors as keyholes and insulin is the key that opens the door to allow glucose into the cells. Insulin acts as a regulator of glucose transport and is responsible for healthy metabolism in the body.

Insulin is called the “hunger hormone”. Blood sugar level increases after a meal (as glucose is produced by the food we eat). To correspond to the rise in glucose, insulin level rises to infuse the cells with that glucose. When the  blood sugar has been utilized and energy from that glucose has been utilized by the cell to create energy, blood glucose slowly lowers and the body signals the pancrease to “turn off” insulin release. As energy is generated, blood sugar continues to drop until the body needs more glucose.  This triggers hunger. When blood sugar drops to a lower blood sugar level the adrenals are triggered to make more cortisol. Cortisol increases the blood sugar by converting protein and fat “fuel”. The blood sugar again rises to provide a continuous supply of energy for our use between meals. Cortisol therefore works hand in hand with insulin to provide a steady blood sugar level 24 hours a day and keep blood glucose levels in a tightly controlled range.

When the adrenal gland is fatigued, the amount of cortisol production is inhibited making it drop below the normal level, and the amount of  blood sugar available to the cells is reduced. With less sugar, less energy is available to the cells, and fatigue is experienced. As blood sugar levels continue to drop below a critical point, dizziness and lightheadedness is often experienced. These are common symptoms of hypoglycemia (also called hypoglycemia). Low blood sugar is most likely experienced between meals at 10am-12pm, as well as 3-4pm and can be avoided by making sure all meals contain some protein.

Here’s the kicker, the body’s automatic response when more sugar is needed during times of stress is to make more insulin in an attempt to move the sugar faster into the cell from the blood stream to create more energy. Insulin opens up the cell membrane to push the glucose in, resulting in further reduction in blood glucose. This worsens the already existing hypoglycemic state.

Those suffering from adrenal fatigue often report symptoms of hypoglycemia such as dizziness and weakness, as the blood sugar level drops below a comfortable level for the body to function normally. This is often why your body triggers the need for a quick fix solution such as foods high in refined sugar (donuts, candy bars, or other sweets), or drinks that is stimulatory to get the adrenal to put out more cortisol (A Venti Latte or a Big Gulp). This often will create the needed boost of energy but with a price. This relief from this hypoglycemic state only lasts for about a few hours. Inevitably, blood sugar levels crash and fall to even lower levels. Those with adrenal fatigue are on a constant roller coaster ride with their blood sugar level throughout the day. The blood sugar level tends to increase after each quick fix, but drops after a few hours. By the end of the day, the body is utterly exhausted.

Maintaining constant and consistent blood sugar levels in the blood is a critical consideration in adrenal fatigue recovery.  Eating small snacks in between meals, ensuring protein is consumed with each meal along with a little healthy fat such as olive oil, avocado, or coconut oil (orcoconut butter)  Starchy carbohydrates that are converted quickly into glucose (such as pasta and bread) should be limited. Soda drinks should be totally avoided.

Note:: During the recovery from OAT Axis Imbalance, I find restricting grain to be helpful to controlling blood sugar as even whole grains break down to glucose and I find it more effective to increase vegetables and fruit consumption.


The amount of salt in the body is highly dependent and regulated by a steroidal hormone called aldosterone. This hormone is manufactured in the adrenal cortex under the direction of another hormone called ACTH (adrenocorticotrophic hormone). ACTH is manufactured by the anterior pituitary gland. ACTH stimulates the adrenal cortex to secrete a myriad of hormones including aldosterone as well as cortisol. Like cortisol, aldosterone follows a  similar daily pattern of secretion, peaking at 8 a.m. , and at its lowest point between 12-4 am. Aldosterone is a very specific compound that is responsible for maintaining the concentration of sodium and potassium in the cell as well as outside the cell. This, in turn, has a direct effect on the amount of fluid in the body. Aldosterone  plays a significant and integral role in regulation of blood pressure.

It is important to note that in the body, sodium and water goes hand in hand. Where sodium goes, water follows. As the concentration of aldosterone rises in the body, the concentration of sodium and water rises, more fluid is retained in the body, and blood pressure rises. Conversely, when the level of aldosterone lowers, the amount of sodium and water in the body is reduced. The blood pressure goes down.

Unlike cortisol, aldosterone does not have its own negative feedback loop when there are excessive amounts. If the aldosterone levels elevate, aldosterone receptor sites will be down regulated and its sensitivity to aldosterone is reduced. In the early phases of adrenal fatigue, the amount of cortisol and aldosterone increases in the body due to the ACTH stimulatory effect from stress. As a result, sodium and water is retained in the body leading to a bloated feeling. The baro-receptors ( receptors that are sensitive to pressure) of the blood vessels are triggered and blood vessels relax automatically. This is regulated by the autonomic nervous system. This auto-regulation helps to maintain a stable blood pressure at a time when the total fluid volume increases due to high level of aldosterone triggered by stress.During times of stress, the adrenal glands also secrete another hormone called epinephrine. This hormone constricts the blood vessels and increases blood pressure in order to ensure that our brain have adequate blood flow and oxygen to help us deal with impending danger (fight or flight). The sum total reaction of aldosterone, epinephrine, and the autonomic relaxation response are some of the important factors that ultimately decide the final blood pressure at any point in time. During the early stages of adrenal fatigue, the resulting blood pressure is often normal if all bodily function is well balanced. If the body is unable to overcome the aldosterone and epinephrine response, then the blood pressure rises. It is common to find times of stress cause increases in blood pressure.

As adrenal fatigue progresses to more advance stages, the amount of aldosterone production decreases.  The ability to retain sodium and water is compromised. As the fluid volume is reduced, blood pressure falls. Cells become dehydrated and become sodium deficient.  Adrenal fatigue sufferers become chronically and often acutely dehydrated.  Water with a pinch of celtic sea salt can stem the tide of this dehydration. Coffee, alcohol, and tea (with the exception of herbal tea) should be avoided.

Most with advanced adrenal fatigue report experiencing low blood pressure as well as a salt craving. Low blood pressure is due to reduced fluid in the body. Salt craving happens because the body is crying for necessary sodium. Both are due to the lack of aldosterone. In order to compensate for this lack, potassium is leaked from the cells so that the sodium to potassium ratio remains constant. The loss of potassium is less then that of sodium, and as a result the potassium to sodium ratio is increased. This imbalance causes yet another set of problems.

Sufferers of adrenal fatigue often have a low body fluid volume accompanied by a salt craving due to a deficiency in sodium as well as a normal to high potassium level. While lost fluids must be replaced, it should be done carefully and slowly. When fluid is replaced too quickly without adequate sodium, the amount of sodium in the body becomes diluted, resulting in an even lower sodium level. This is called dilutional hyponatremia. Symptoms of low sodium includes non-specific symptoms confusion, lethargy, nauseated, headache, seizure, weakness, restlessness. Adrenal fatigue along with low sodium levels tends to challenge all but the most experienced health practitioner. Many doctors just “miss” the sub-clinical symptoms of adrenal fatigue.

Those in this state may find themselves visiting the ER as a result of these downright scary symptoms only to be told that all is normal after an extensive blood workup. Electrolytes may actually fall within normal range yet symptoms persist among those whose adrenals are advancing towards adrenal exhaustion. Some may need diuretics to reduce fluid load while sodium balance is being replaced. Symptoms can take awhile to resolve.

Sufferers of advanced adrenal fatigue usually have a low cortisol and low sodium levels. Drinking water with one half  to one teaspoon of  celtic sea salt, or better yet, the juice of two oranges and one half to one tsp. Celtic sea salt with 1 tablespoon of gelatine on a regular basis, will help nourish adrenals, and keep both thyroid and insulin levels balanced.

To fine-tune your eating, specific to you, your particular health struggles and metabolic needs, contact me  to enquire about a private consultation; either in person in the Middle East, on certain dates in my travel schedule, or long distance via Skype.


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  1. mary says

    Fantastic and realistic advice! Am sure a lot of adrenal fatigue can be stopped on it’s tracks if caught early enough. It’s all too easy to ignore the symptoms until things get so bad you are forced to do something. So easy to be out of balance with the typical life-style these days but a little bit of care and self-nuturing are vital to stay healthy and prevent imbalances in the first place – and if things have gone downhill already there is a path back and following this advice will certainly help, though as this article says, everyone is unique so one size/solutuon doesn’t fit all but whoever you are, I agree that minimizing stress is the no.1 thing to do!

    • thedetoxdiva says

      I am really glad you got some use out of this post Mary. I sometimes wonder if anyone is listening but it is nice to know that people like you really take in what is said. I value you as a reader and friend.

  2. mary says

    Thank you! And likewise, I value you as both friend and an incredible source of information/help which you give so generously. I am sure people are getting a lot out of it but I suppose it’s a lot to take in and the OAT axis stuff is complicated. But then, if you want to heal from it you have to understand what is happening so I do really think this post and the previous one give a clear and graspable understanding of the complexities. Please keep writing your wonderful posts. The world needs information like this!

    • thedetoxdiva says

      Fresh orange juice helps modulate blood sugar and calm down the adrenal glands. If you add about 1/4 tsp of sea salt to your orange juice, this will raise your blood sugar to normal and lower damaging stress hormones. Salty fruit juice helps stimulate the conversion of T4 to T3 . The glycine in the gelatine further facilitates insulin’s action in lowering blood sugar and increasing insulin sensitivity. Because I know not many people will drink 4 to 6 cups of bone broth a day and most people consuming meat are consuming muscle meats, adding gelatin to the diet enhances glycine in the diet further. Drinking it in the orange juice is a pleasant way to “get it down.”

  3. says

    Due to financial need, I work evenings (to be home with my daughter during the day) and yet still have to get up early to get my son off to school in the mornings. My health has declined since my kids were born (chronic inflammation, fatigue, neck and back pain), probably due to the lack of a decent night’s sleep. I’ve made huge improvements over the past year or so: I lost all my extra weight, consistently exercise (but nothing too taxing), adopted a primal diet, epsom salts baths, detoxed the house and all our products, and by making myself more of a priority; but I’m still not where I need to be. Just when I think I’m doing great, I’ll spend 2 weeks barely able to move, and exhausted beyond belief. At the moment I’m dealing with brain fog, neck and low back pain, digestive issues, dizziness, and constipation. Last week, I felt like a million bucks. I know my work schedule has a lot to do with this, but I’ve stressed myself extensively trying to find another way to get by financially, and have yet to find an acceptable alternative. I just don’t know when I’ll be able to change my schedule, and I’m trying to make peace with it for now to reduce the stress it’s causing me.

    For this adrenal soothing orange juice…can you tell me the importance of the celtic sea salt? I actually have oranges and grassfed gelatin in the house, but the salt I have is the Field Day Mediterranean Coarse Sea Salt. It’s additive free, unrefined and kosher certified. Would this salt suffice for now, or is there something essential in the celtic sea salt?


    • thedetoxdiva says

      The sea salt helps manage the adrenals on many levels; aldosterone, potassium, even calcium levels are affected by the sea salt and provided your salt is grey (not white) and a little moist it’s perfectly fine. It would suffice perfectly! The combination of the orange juice and sea salt is extremely nourishing for your adrenals, is pro-thyroid and prevents hypoglycemic reactions which are all part of the OAT Axis imbalance. You sound like you need to consider a private consultation (I can work with you in that respect) to really pinpoint what needs to be balanced first and even consider some supplementation to support the organs as they repair! You are doing good things from the sound of it, but sometimes the organs really just need a little more support to help them heal more rapidly.

  4. Ally says

    Hi, I have been incorporating a raw carrot into my diet daily for about a week, any tips on stopping the gas build up I get about half an hour after I eat it.

    • thedetoxdiva says

      Ally, if you are noticing a gas buildup after eating a carrot that means your gut needs repairing. I would encourage you to start adding gelatin and bone broth to your diet as well as making sure you are getting enough protein as well as fruit as all these things help heal the intestinal tract in addition to cutting out grains. When the gut is strong the gas buildup will be dramatically reduced if not eliminated.

  5. Ally says

    Thank you so much for your reply. Yes I was wondering about my gut health! I gave up grains about 18 months ago only having the occasional brown rice cracker. I would be interested in your thoughts on coconut flour to try and make some muffins, I don’t like to use almond flour too often. I get plenty of protein. In regards to fruit how much is too much, I always have 2 pieces with a handful of frozen blueberries in my smoothie, is this okay or could I add some more. I also have ordered the gelatin and am awaiting it’s arrival, should I start with 1 tablespoon?
    Once again thankyou.

    • thedetoxdiva says

      Hi Ally,
      I wouldn’t use almond flour at all. (nor would I be having brown rice crackers.) Coconut flour, with an impaired gut, can be problematic and fibrous but if your digestion is strong, a little won’t hurt you. You say you get plenty of protein. How? In what form? Spread your fruit out and don’t worry about getting too much. You have to eat a LOT to get too much. Start with 1 tablespoon and work up from there with the gelatin. I add it to everything!

  6. Ally says

    You will be disappointed I know, but protein is not grass fed and free range, affordability is a huge problem and especially with a big family to feed. I totally understand about the grains etc. I’m assuming when the gut is healed I will be able to have a bit of almond flour, rice etc. Is this a long process? Are there any grain free flours that aren’t inflammatory that I could use now to make a treat every once in a while? Many thanks.

    • thedetoxdiva says

      I don’t like almond flour because of the amount of PUFA it contains. That’s not a matter of a healthy gut or not because you want to decrease your amount of PUFA in your body. You can have white rice anyway. Yes, it can be a long process depending on the damage to the gut. I make tons of treats with NO flours at all, including brownies, custards, ice cream and panna cottas.

  7. Jone says

    Hi, this article and the previous article had great information and advice. Might I suggest one more tip to add in these articles? Get your gut tested. For me, I saved up and quit my job and made sleep a priority, relaxation, eating, everything. But I could not heal everything because I had fungus (from 3 rounds of antibiotics in the previous 8 years, I assume) and H Pylori, and a Magnesium deficiency – all diagnosed by functional testing. I wouldn’t be anywhere without those tests.

    Just thought I would share my two cents, other than that, great article.

    • thedetoxdiva says

      Jone I talk a lot about gut health in other articles. I also focus on rebuilding gut health in treatment. You are absolutely correct that this is a big issue when balancing the health and SHOULD be a priority.

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