Redefining Strength with Adrenal Insufficiency

What happens when the body you trusted to carry you through exercise suddenly stops responding the way it used to?

In this episode, Noah and Eloise take a deep dive into the My Adrenal Life article “Muscle Atrophy, Exercise, and Finding Balance with Adrenal Insufficiency.” Together, they explore one of the most painful and confusing realities for many people with adrenal insufficiency: the loss of physical confidence, the grief of changed limits, and the challenge of learning what strength looks like now.

For people living with primary adrenal insufficiency (Addison’s disease), secondary adrenal insufficiency, tertiary adrenal insufficiency, or steroid-induced adrenal insufficiency, exercise is not simply about motivation or conditioning. The body’s normal cortisol response to exertion is altered or absent, which changes how muscles access energy, recover, and adapt to physical stress.

Noah and Eloise explain why this is so biologically significant. Cortisol is often misunderstood as just a “stress hormone,” but it also plays a major role in fuel availability, blood pressure support, and exercise recovery. Without enough available cortisol, the body may struggle to release stored glucose efficiently during activity, which can lead to shakiness, dizziness, weakness, nausea, and the sudden feeling that the system is shutting down.

The episode also explores the role of myostatin, a protein that acts like a brake on muscle growth. In low-cortisol states, myostatin activity may increase, which helps explain why some people with adrenal insufficiency experience real muscle atrophy, weakness, and difficulty rebuilding strength, even when they are trying hard to stay active.

Another key theme in the conversation is the difference between fitness culture and adrenal reality. Messages like “push through,” “no pain, no gain,” and “just train harder” can be deeply harmful in adrenal insufficiency. What feels like ordinary exertion for one person may create a dangerous physiologic drain for someone whose body cannot mount a normal stress response.

Noah and Eloise also talk about the emotional side of this shift. For people who once identified strongly as runners, athletes, lifters, hikers, or simply physically capable people, adrenal insufficiency can feel like waking up in a body that no longer follows the same rules. That loss can carry real grief, frustration, and shame.

But the episode does not end there.

Instead, it reframes strength. Movement is still valuable. Exercise can still support mood, circulation, muscle preservation, and bone health. But the strategy often has to change. The discussion highlights more sustainable approaches like longer warm-ups, stopping before complete exhaustion, paying attention to warning signs, and favoring strength work or steadier movement over relentless endurance training when needed.

At its core, this episode is about building a new relationship with the body - one based on listening rather than forcing, partnership rather than punishment, and adaptation rather than self-blame.

If you have ever wondered why exercise feels so different with adrenal insufficiency, or why your body seems to hit a wall other people cannot see, this conversation helps explain what is happening under the surface.

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