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The Ovarian - Adrenal - Thyroid (OAT) Axis

Poor adrenal health can have a downstream effect on other hormones.

The adrenals are part of a hormonal circuit called the ovarian adrenal thyroid (OAT) axis. The OAT axis consists of:

🔹 The adrenals glands

🔹 Thyroid

🔹 And ovaries.

Each element of the OAT axis has an impact on the other two, this means that when one component of the axis becomes out of balance, the rest suffer as a result.

Estrogen / Progesterone

Estrogen dominance and adrenal fatigue go side by side. One of the precursors to cortisol is progesterone. When the body is stressed and needs to pump out more and more cortisol, it needs more and more progesterone. This can lead to an imbalanced ratio of estrogen - progesterone, causing a phenomenon that’s often called estrogen dominance.


Excessive stress hormones circulating in the blood can impact enzymes that convert T4 to T3 (the active form of thyroid hormone). When stress hormones are high, this can lead to hypothyroidism if not enough of T3 is circulating. This is why you'll often encounter women with hypothyroidism who also have adrenal fatigue and sex hormone difficulties.


The adrenal glands are also responsible for producing DHEA. DHEA is a precursor to both estrogen and testosterone. When the adrenals are overproducing cortisol, and under producing DHEA this can lead to low testosterone levels and symptoms such as low energy levels, low libido, weight gain, weak bones, and depression.

The good news is that supporting one aspect of the OAT axis will also benefit the others. And, in many cases, the resolution for resolving issues in one component is the same resolution for resolving issues in another.

Key ways to support the OAT axis:

Wake up at the same time everyday

Your circadian rhythm is the 24 hour built in body clock. This helps you to know when it’s time to sleep and when it’s time to be awake. A healthy circadian rhythm often follows the sun’s light/dark cycle. Your circadian rhythm loves predictability! Aim to get up about the same time every day, even on the weekends!

Get sunlight

After you wake up, spend about 10 minutes getting direct sunlight on your face. Your brain stops producing melatonin (your sleep hormone) when you're exposed to light, which can make you feel more awake as a result.

If there is no sunlight when you wake up, you can get an inexpensive sun light off Amazon to help with this.

Stress management.

This is the most important factor in preventing an imbalance within the OAT axis. Avoid stressful events as much as possible. Pay attention to what your body is telling you, and keep your stress levels under control through natural stress-relieving techniques such as:

  • Walking

  • Meditation

  • Journaling

  • Exercise

  • Yoga

  • Fulfilling social connections

Engage in the right amount of exercise (not too much, not too little).

Exercise has been proven to help reduce stress levels. The key here is to exercise the right amount of time so that your adrenals aren’t getting depleted. This could mean doing some yoga, or even walking! Make sure to exercise either in the morning or early afternoon to avoid impacting your sleep.

Avoid certain foods.

Consuming certain foods can lead to a stress response within the body. Eliminate any difficult-to-digest foods as well as foods that cause inflammation. This includes the following:

  • Sugars and sweeteners

  • Hydrogenated oils

  • Carbohydrates

  • Processed meats

  • And other processed foods.

Blood sugar management.

Low blood sugar is a common cause of cortisol release and is not uncommon in those struggling with chronic fatigue syndrome or hormone imbalances. Here’s what you can do to balance blood sugar levels:

  • Eating enough fiber

  • Including fat and protein with every meal

  • Limiting carbohydrates

  • And staying hydrated.

Reduce or avoid caffeine intake

Caffeine can disrupt your sleep pattern and make it difficult for your adrenal glands to recuperate. When healing from adrenal dysfunction, it’s often better to avoid caffeine all together as it adds unneeded stress on your adrenals.

Have an early dinner

The timing of when you eat can affect your circadian rhythm. Late dinners can make it difficult to fall asleep, so eat your final meal two to three hours before bedtime. This will allow your body to digest the meal properly and get your body used to a routine. Try to avoid alcohol and caffeine.

Turn off devices 2 hours before bed

The blue light from devices can reduce or inhibit melatonin production, which can leave you feeling wide awake while laying bed.


Getting enough sleep is necessary to support all hormones within the body. Aim to sleep for around 8 hours per night and avoid staying up late regularly.

Use adaptogens

Adaptogens help the body to become more resistant to stress and decrease the overall sensitivity to various stressors.

8 adaptogens to support the adrenals:

  • Licorice root

  • Ashwagandha

  • Holy Basil

  • Maca

  • Reishi mushrooms

  • Ginseng

  • Rhodiola

  • Eleuthero

(Note: always check with your healthcare provider before starting / stopping any supplements)

If you strive for a balanced lifestyle that includes adequate sleep, exercise, a healthy diet and environment, your ovarian adrenal thyroid axis is likely to remain healthy.

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