As many of you know, I am training for the Big Sur Marathon in just under 4 weeks. Even though I am checking this race off my bucket list, marathon running is not something I recommend to my patients. Running 26.2 miles is hard on the body. Its hard on your joints and can cause hormonal imbalances. While endurance training improves cardiovascular and respiratory health, it places prolonged stress on the body. Whether you are training for a 10K, half marathon, or marathon it is important to protect your adrenal glands to prevent symptoms associated with hormonal imbalances.




Adrenal glands are small structures that sit on top of the kidneys, almost like top hats. These small glands produce a number of essential hormones including: aldosterone (a hormone that helps with sodium (salt) balance in the body and blood pressure), cortisol (your primary stress hormone) and dehydroepiandrosterone or DHEA (an important androgen in both females and males).

There are two primary diseases associated with adrenal dysfunction including Cushing’s (too much cortisol or overactive adrenals) and Addison’s (too little cortisol or adrenal insufficiency). However, in Functional Medicine we believe there are early signs and symptoms of adrenal dysfunction that need to be addressed.

Check out my previous blog for additional information about how stress impacts the body.




  • Blood sugar instability
  • Salt cravings
  • Fatigue
  • Inability to sleep (tired and wired)
  • Weight gain
  • Decreased muscle tone
  • Anxiety or depression
  • Brain fog
  • Dry, thin skin
  • Blood pressure instability
  • Weakened immune system


Endurance training places individuals at higher risk for adrenal dysfunction due to prolonged stress on the body. It is important to remember that stress can be both physiological and psychological. Endurance training causes physical stress on the body, which increases the stress hormone, cortisol for an extended period of time. Then you add the psychological work and life stressors that everyone has to some degree and before we know it our adrenals have taken a beating. Therefore, it is crucial to implement these 5 tips into your lifestyle to preserve your adrenal glands, optimize physical performance, and increase longevity.




  1. Schedule REST days. This is an essential time for your mind and body to recover. You need at least 24-48 hours of rest after your long endurance training days. During these rest days, I encourage activities such as yoga, taking a warm Epsom salt bath, doing some light stretching, or going for a leisure walk.
  2. Aim for at least 7.5 hours of sleep per night (optimal 8-9 hours of sleep). The harder you are training the more sleep your body requires. Focus on good sleep hygiene. Turn off all electronics 30 minutes before bed, begin dimming lights, and do a quiet activity such as reading a book or meditating.
  3. Stabilize your blood sugar throughout the day. Low blood sugar increases cortisol levels. It is important to eat well-balanced meals and snacks throughout the day to stabilize blood sugar and prevent cortisol spikes throughout the day. I recommend reducing, if not avoiding, processed foods, sugar, and caffeine.
  4. Take a good vitamin B complex. Find a good, third party tested vitamin B complex with both B5 and B12 (such as basic B complex by Thorne), which are specifically important for optimal adrenal function.
  5. Still symptomatic? Add adaptogen herbs to help balance your adrenal hormones. A few of my favorites include: holy basil, ashwaghanda, and rhodiola. These herbs will help balance high or low cortisol levels to help your body maintain homeostasis or balance.

Always remember hormones are intricate and complex. If you are still experiencing symptoms, I would love to talk with you!

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