The Experience Miracles Podcast

Wound Up & Worn Out: Overcoming Adrenal Burnout in Families

Jan 7, 2025

Adrenal Burnout in Kids: HPA Axis, Root Causes, and Natural Reset Strategies

Episode 67 — Experience Miracles Podcast | Host: Dr. Tony Ebel, DC, CACCP — Pediatric Chiropractor & Founder of PX Docs | Published: January 7, 2024 | Duration: ~145 min Guest: Ali Miller, RD, LDN, CLT — Registered Dietitian, Functional Medicine Practitioner & Founder of Naturally Nourished

Key Takeaways

  • The HPA axis (hypothalamus-pituitary-adrenal) is the body’s master stress-response system. When it’s chronically activated by medications, birth interventions, and environmental toxins, children burn out their adrenals — producing a cycle of anxiety, fatigue, and developmental regression that conventional medicine rarely addresses at the root.
  • Ketones are a neurologically superior fuel source that cross the blood-brain barrier, reduce oxidative stress, and upregulate GABA — the brain’s primary calming neurotransmitter — making a low-glycemic, ketogenic-leaning diet especially valuable for children with anxiety, seizures, and Sympathetic Dominance.
  • Steroid medications (inhalers, nebulizers) and stimulant ADHD drugs are among the top drivers of adrenal burnout in children, disrupting the HPA axis feedback loop, suppressing natural adrenal output, and contributing to growth delays and severe anxiety.
  • A chiropractic adjustment targeting the T7–T10 thoracic region — which directly governs the viscero-somatic relationship between the spine and the adrenal glands — can physically break a stuck stress cycle that supplements and breathwork alone cannot reach.
  • According to the CHIRP study discussed in this episode, maternal distress during pregnancy was the #1 factor in childhood chronic illness, and EMF exposure ranked #3 — reinforcing that nervous system dysfunction often begins before a child is born.

Why Are So Many Kids Hitting Adrenal Exhaustion?

Adrenal exhaustion in children is not a rare edge case — it is increasingly common, and it begins earlier in life than most parents or practitioners expect. The HPA axis (hypothalamus-pituitary-adrenal axis) is the central command loop for how the body responds to stress. When a child’s nervous system stays chronically locked in Sympathetic Dominance — fight-or-flight mode — the adrenal glands are forced to continuously produce cortisol and stress hormones until, eventually, they can no longer keep up.

What drives children into this state? According to Dr. Tony Ebel, DC, CACCP, and registered dietitian Ali Miller, the most common culprits are steroid medications prescribed for respiratory issues (inhalers, nebulizers), stimulant ADHD medications, birth interventions like induction and C-section, high maternal stress during pregnancy, and chronic low-grade infections. Each of these stressors hijacks the HPA axis in a different way, but the end result is the same: a child whose adrenals have “packed a carry-on bag and moved to Mexico” — depleted, dysregulated, and no longer able to restore balance on their own.

The distinction this episode drives home is that adrenal exhaustion is not simply “burnout” in the adult sense. In children, it presents as severe early-onset anxiety, developmental regression, growth delays, and a nervous system so depleted that the child cannot benefit from nutrition, supplementation, or therapy until the underlying physical cycle is reset. That reset — as both speakers make clear — often requires a direct intervention at the nervous system level before any other healing can take hold.

Introduction: Ali’s Background and the “Doctrine Creates Disconnect” Principle [00:01 – 00:08]

Dr. Tony Ebel: On this episode of the Experience Miracles podcast, I am thrilled to sit down and interview Ali Miller, a registered dietitian with a contagious passion and extensive experience using food and nutrients to help heal the body. Her expertise has been featured in Oprah magazine, MindBodyGreen, and Women’s Health, and she has written multiple books. Her upcoming book is going to be life-changing for your family.

Listen all the way to the end of this one — the Adrenal Conversation, the Adrenal Reset, the Nervous System Conversation using both of our expertise really is going to land for so many moms who are just exhausted and have tried everything to fix their hormones and their adrenals. Let’s get into it.

Ali Miller: Just to clarify for listeners — Naturally Nourished is my brand and I have a clinician and podcast co-host, Becky, who will be co-authoring Naturally Nourished Kids. I started Naturally Nourished in 2013 as a functional medicine clinic. I wrote The Anti-Anxiety Diet and The Anti-Anxiety Diet Cookbook independently. The driving force behind everything has always been food as medicine.

I was a dance major initially and quickly shifted into the locavore movement at my university. That eventually led me to make a wrong turn — becoming vegetarian, then vegan. I went to Bastyr University believing that being a raw vegan was the way to heal the body, and while I was there, I started to experience panic attacks for the first time at age 21 or 22. I realized very quickly that what I perceived as an optimal diet was really driving nutritional deficiency and creating havoc on my gut.

That experience gave me one of my core principles, which I use in The Anti-Anxiety Diet: doctrine creates disconnect. We can get really passionate about a module on detox or hormones, but when you’re listening to influencers and excited about something that changed your life, we have to remember we are evolving beings. Hormone fluctuations, stress loads, environmental exposures — all of it constantly shifts what “optimal” means for any individual.

Why Personalized Care Beats Cookie-Cutter Protocols [00:08 – 00:12]

Dr. Tony Ebel: As you steer your patients down that road, how do you help them get excited about customized care without getting overwhelmed?

Ali Miller: Functional labs are the foundation, because we love to say “test, don’t guess.” I see far too often in the functional medicine space that we can get just as algorithmic as conventional doctors. In conventional medicine it’s “here’s hyperlipidemia, give them a statin.” In functional medicine, the same trap exists — see this problem, apply this protocol.

A good practitioner will take time to understand the upstream antecedent — the triggering force — while also addressing the downstream symptoms. For someone with elevated triglycerides, yes, I’ll recommend omega-3 fatty acids. But I’m also going to assess fasting insulin levels, put a CGM on them, and look at how they’re metabolizing glucose. Often, stress alone is driving dysglycemia through the glucagon connection — because cortisol is a glucocorticoid.

“Stress is the Achilles heel to wellness. If you don’t manage the HPA axis, there’s going to be a whack-a-mole situation of disease and dysfunction — and you’re just dancing from organ system to organ system watching what’s going to burn out next.” — Ali Miller, RD

I have three grounding hypotheses I come back to with every patient. First, stress is the Achilles heel to wellness. Second, we were all designed as hybrid beings — every human should have access to using ketones as fuel, because it is a lower-oxidizing, powerfully neurological energy source. Third, we were designed to be omnivores. How meat-heavy or plant-heavy any individual needs to be will vary, but the framework holds across all three.

Ketones, GABA, and Why Brain Fuel Matters for Kids [00:12 – 00:22]

Dr. Tony Ebel: I want to pull on the ketones thread. The reason a ketogenic diet is proven helpful for seizure patients is that any extra oxidative metabolic stress to a child whose Sympathetic Dominance is already elevated is known to trigger a seizure. That’s why weather changes, stressful events, and poor diet can all set one off. Keto minimizes that oxidative burden. Same mechanism explains why it’s also used for Autonomic Nervous System regulation in panic attacks, anxiety, bipolar disorder, and manic-depressive disorder.

Ali Miller: Exactly. Ketones cross the blood-brain barrier, and when they do, they fuel the mitochondria as the most efficient fuel source — producing the least oxidative stress. Oxidative stress drives inflammation, so the brain is already in a less inflamed state when ketones are present.

We also know that ketones are GABAergic — they upregulate the expression of GABA. GABA is the unsung hero of mental-emotional regulation and neurological health. It is a neuroinhibitory compound — a “mellower-outer” for the brain and mood — but crucially, it is non-sedative. It vents the steam train of epinephrine response in the body. It mellows out the surging we experience, yet research shows it still supports academic performance, concentration, and focus.

They’ve actually measured GABA in basketball players shooting free throws when they’re in the zone — GABA is elevated in those moments.

I support GABA regulation through the brain-gut axis, through a ketogenic approach, and sometimes through bioidentical GABA supplementation. My own eight-year-old self-advocates for GABA Calm before performances because she understands it helps her stay in her zone without that anticipatory stress interfering.

Dr. Tony Ebel: Anytime I’m on stage, I take GABA Calm because the adrenaline of loving what I do — wanting to perform, wanting to show up — I still want to look calm and not have that tremor of adrenaline stress response that I’d otherwise get. It is one of those tools that takes down so many positive roads, especially when you apply it to the toxic, overstimulated world our kids live in today.

The HPA Axis Explained: From the Hypothalamus to the Adrenal Glands [00:22 – 00:36]

Dr. Tony Ebel: Let’s give the community the right foundation. How essential is the stress conversation — the adrenal, HPA axis conversation — to everything else: the gut, the immune system, every other piece?

Ali Miller: The HPA axis is the hypothalamus and pituitary in the brain, plus the adrenal glands that sit above the kidneys. The Autonomic Nervous System is either in sympathetic fight-or-flight or parasympathetic. I’m really sad that parasympathetic was taught — and still is taught — as simply “rest and digest,” because it truly is the regulation function of the body.

Dr. Tony Ebel: My writing team got a Slack message from me this week: if anyone describes parasympathetic as rest-and-digest only, retrain that immediately. It is the regulation side of the system. That’s it.

Ali Miller: The hypothalamus regulates the body’s overall homeostasis. That means body temperature, growth hormone, sexual hormone stimulus, thyroid releasing hormones, sleep and wake patterns, and leptin targeting. Leptin is not just a satiety signal — it is a safety signal. When we see teens with hypothalamic amenorrhea from disordered eating, it’s because the hypothalamus didn’t receive that leptin signal saying “we’re safe, we’re fed.” It triggers the pituitary to suppress sex hormone as a survival mechanism.

The pituitary controls FSH and LH for women’s hormones, adrenal stimulus through ACTH, and oxytocin. Oxytocin is the bliss factor — God’s way of helping us feel safe, loved, connected, and trusting. It’s a powerful anxiolytic compound released through touch and connection.

“Oxytocin is released at times of touch, connection, and safety. It is such a powerful anxiolytic compound — and physical touch, through proprioception, is a direct pathway to it.” — Ali Miller, RD

Dr. Tony Ebel: That is our cheat code as chiropractors. We use physical touch, and we can trace the neurophysiological mechanism through proprioception, into the sensory system, into the cerebellum, through to the hypothalamus.

Ali Miller: During what I call “the bad season,” my number one recommendation for patients who were struggling — particularly isolated adults — was to get at least biweekly chiropractic, acupuncture, or massage, because they needed to be touched by someone. I had one patient, an MIT-trained rocket scientist, whose blood sugar was most stable when he was taking ballroom dancing classes. It wasn’t the exercise. It was the touch with a partner and that oxytocin connection.

The hypothalamus-to-adrenal pathway continues through the adrenal cortex, where we make cortisol — the star of the stress story. Cortisol cannot be demonized or made a hero. Too little cortisol drives chronic fatigue, systemic inflammation, and immune susceptibility. Too much drives the opposite pattern. The key experiential hit from chronically low cortisol is usually chronic pain, inflammation, fatigue, and brain fog.

How Kids Burn Out Their Adrenals: Medications, Birth Interventions, and The Perfect Storm [00:36 – 00:57]

Dr. Tony Ebel: Let’s talk about children specifically. What pushes a kid’s adrenals so far over the cliff that they go low cortisol?

Ali Miller: The most common driver I see with children is steroid use. Usually it’s respiratory dysfunction — inhalers, nebulizers — that puts them on excessive steroids, which burns out the adrenals over time. Often these kids are dealing with growth delays because the whole HPA pathway is broken. The pituitary isn’t focused on growth hormone — it’s focused on stimulating the exhausted adrenals because the feedback mechanism has been disrupted.

With teens, another significant medication-induced driver is stimulant medications — Adderall and similar drugs. We’re essentially giving them methamphetamine, constantly keeping their HPA axis and adrenal feedback in surveillance and survival mode. It does not allow the body to feel safe, which is why appetite is dysregulated in those kids.

Silent chronic infections are another factor — Lyme disease, mold toxicity, Epstein-Barr — where a corticosteroid response is continuously trying to regulate the inflammation.

Dr. Tony Ebel: I want to add the physical mechanism. We run an intensive program in our office outside Chicago and my specialty is The Perfect Storm — the whole story of dysregulation, Subluxation, Sympathetic Dominance, and Dysautonomia.

Last month we took on a two-year-old on three different psychotropic medications — she went into regressive autism because she has The Perfect Storm, on steroids. And I mean that literally, not figuratively. This child had an induction birth.

What induction birth does is short-circuit the neuro-biomechanical-respiratory cascade. C-section birth does this. Fast birth does this. The upper cervical spine is the most discussed area in birth intervention literature, but the thoracics — the upper, middle, and lower thoracics — are essential to endocrine function, digestive function, and diaphragmatic respiratory function.

“The path to anxiety in a child is induction and inhalers. I see it so often: induction birth, followed by respiratory struggles, followed by steroids. That combination throws a child’s neurochemical developmental system off — and the adrenals get pissed off by it.” — Dr. Tony Ebel, DC, CACCP

This child with the induction birth struggled to breathe and move the ear, nose, and throat lymphatics. She was a poor plumber — couldn’t kick an infection, couldn’t move mucus through. Medicine said it was all normal. Chronic ear infections: normal. Strep, RSV, croup: normal. So they loaded her up on inhalers and nebulizers. I never find many people talking about steroids the way we rage against antibiotics, but the pathway is the same.

Practical Reset Strategies: Supplements, Breathwork, and Food as Medicine [00:57 – 01:21]

Dr. Tony Ebel: For families whose kids are already at neurological exhaustion — total burnout — what are your first moves?

Ali Miller: I always start with DHEA testing. DHEA is a precursor to estrogen and testosterone, made in the adrenal cortex. It plays a role in metabolic health, muscle retention, and has a stem cell-like response in the central nervous system. There aren’t established reference ranges for children, but if levels are falling low, DHEA supplementation is often warranted.

I also use adrenal glandular — bovine adrenal gland — much the same way we’d use a Nature-Throid instead of a synthetic thyroid hormone. We’re giving the gland from an animal to provide the compound in a more wholesome form. Combined with targeted B6, vitamin C, and magnesium bisglycinate — which can cross the blood-brain barrier and actually down-regulates ACTH stimulus from the pituitary, acting like a bodyguard to prevent the cortisol stimulus — these form the core nutritional foundation.

Breathwork is one of the best ways to harness the HPA axis directly. I use the 4-7-8 technique: inhale for four counts, hold for seven, exhale for eight through pursed lips. Think of it as compressing the air out of an inner tube. That extended exhale-to-inhale ratio supports Vagus Nerve recalibration and parasympathetic activation. Research shows just a couple of cycles is effective.

The key is that breathwork must be practiced proactively — like lifting weights. You need those muscles strong before the fight. Practice it before school, at the lunch table, even in a bathroom stall if that’s where your child feels safe.

For food as medicine, getting right on circadian rhythm matters enormously. Getting access to sunrise and sunset, getting outside for at least one to two hours per day — that natural infrared light is anti-inflammatory in ways we’re only beginning to measure. Rebounding and activities that activate G-force are particularly good for Vagus Nerve regulation.

Gargling salt water is one of my favorites — especially during cold and flu season. Salt reduces microbial activity, and the gargling creates vibration that acts like a tuning fork for the vagus nerve, pushing the body into parasympathetic state from the inside.

Dr. Tony Ebel: I hear from parents constantly: “We’ve done it all.” When I hear that, I step back and try to understand what they’re actually doing and at what dose. Ali made the point perfectly — if you’re giving 40 milligrams of vitamin C when the efficacious dose for this 60-pound child is 1,200 milligrams, you haven’t actually done it yet. The dose has to be enough to hit reset.

The Chiropractic-Adrenal Connection: The Physical Reset (and Gavin’s Story) [01:21 – 01:45]

Dr. Tony Ebel: There is a physical touch and neuromuscular reset piece that I believe is profoundly missing from the adrenal conversation. In chiropractic, we separate the somatic system — structure, muscles, skeletal — and the nervous system that runs through and organizes it. Most people place chiropractic purely in the somatic category. But the somatic and visceral systems — your organs, your glands — are very much governed by the nervous system, including the Vagus Nerve and the sympathetic nervous system.

Here is the specific mechanism I need more people to know. The adrenals are the one gland that, when they go into absolute stress cycle and then into fatigue, creates a stuck neurological loop. The adrenals need to operate with speed to physically prepare the body for fight or flight — they can kick a neurological sensory message across the dorsal horn, into the muscles, and into the diaphragm.

What we find in our most adrenal-depleted patients — wound up but worn out — is a severe Subluxation, neuromuscular tension, asymmetry, and fixation from roughly T7 to T10. That region is the direct viscero-somatic nerve communication zone between the spine and the adrenal glands.

Everybody assumes that if you adjust the upper cervical spine and Brainstem, that’s the calming adjustment. And it is. But for kids and adults whose nervous systems are most stuck in this stress loop, they need that physical adjustment at T7–T10 to hit reset on the biomechanical, somato-visceral, viscero-somatic adrenal reflex.

The next-door neighbor to the adrenals, neurologically, is the diaphragm. What I see constantly once the adrenals and nervous system go down this loop is that patients start breathing into their traps and upper thoracics. They become literally deoxygenated. We created a clinical protocol — we call it Neurotonal Release to Reset Adjustments — where you clear tension from the traps, clavicle, and shoulders first, then open the bandwidth into the lower thoracics. The moment you make those physical chiropractic resets, it’s like you can see the adrenals themselves take a deep breath and come back online.

“The moment you make these physical chiropractic resets into that access, it’s like you can see the adrenals themselves take a deep breath, get back online. Now you can get all the things this family was trying to get in. You create momentum when momentum had been against this patient.” — Dr. Tony Ebel, DC, CACCP

Ten days ago, we started Gavin — a child from Canada with anxiety, ADHD, and depression, on three medications. He had hit depletion. Hit shutdown. You could see it without being a chiropractor: tension stuck from his diaphragm up, traps up to his ears, simultaneously wound up and worn out.

His parents worked with their prescribing doctor and had him off all three medications within 48 hours. I saw him this morning. His shoulders are down, he’s taking deep breaths, he can regulate. His smile is plastered across his whole face. That kid is back.

If a family has gone that far down the road and can’t seem to hit reset naturally — get into a Neurologically-Focused Chiropractic office. It is not the one thing that does all the healing. But it might be the first move that opens the channels from breath to adrenals to physiology to everything else.

EMF, Environmental Toxins, and the Case for Getting Outside [01:45 – 02:06]

Ali Miller: Intentionally, we’re out here on 15 acres. I really work hard to prevent hijacking of my nervous system by environmental inputs. EMF is such a silent killer. I went deep down that rabbit hole after reading Robert O. Becker’s “The Body Electric” — that book completely changed my understanding of the piezoelectric conductivity of the human body and how our electromagnetic field functions as a living system.

The energetic connection — the ability to be disrupted or restored at the field level — is probably the biggest factor in true nervous system resilience. Getting right with it means reducing the stimulus where you can and restoring the inputs God designed us for.

Dr. Tony Ebel: At the CHIRP study presentation I attended — and I’ll see the updated data this week at the Documenting Hope conference — they ask parents of chronically ill children a 1,500-question questionnaire. The top 10 factors are extraordinary. The number one finding was maternal distress during pregnancy. The number three factor was EMF.

That surprised me — not that it was on the list, but that it ranked that high. I knew enough to move to the country. We live on 20 acres. I actually shut our WiFi off at night with a timer. It blew my mind how significant an electrical toxin this is for a nervous system that is, at its core, an electrical system.

If your baby’s crib is next to the fuse box, next to the fuse panel — different electrical circuitries run at different wavelengths even within a home. The nervous system is a bioelectric system. Every time we expose it to the constant oscillation of artificial EMF, we burden it.

Ali Miller: The most important mitigation is maximizing natural inputs. Connecting to the Schumann resonance, to the Hz of the earth, to why birds chirping and morning sunlight genuinely calm the nervous system — these aren’t soft concepts. There’s a harmonious element to being in the gravitational and vibrational field of the earth as a human being. Connecting into that natural design versus trying to biohack or supplement your way back is often the wrong turn.

Some biohacking tools — vagus nerve vibration, certain TENS units — can be useful as short-term support for severe Dysautonomia. But the foundational reset is nature: outside time, natural light, grounding, community, touch.

Naturally Nourished Kids: Ali’s Upcoming Book and How to Connect [02:06 – 02:25]

Dr. Tony Ebel: For our community — especially our parents who are not just healing their kids but also healing themselves — tell us what’s coming with Naturally Nourished Kids and what your community needs to know.

Ali Miller: The mother and father of the household are the battery — the generators — of the nervous system of the household. It absolutely matters that mom and dad are grounded and balanced if we expect healthy children. That principle is baked into everything we do.

Naturally Nourished Kids comes out in fall of 2025. We’re hoping for September, possibly early October. Becky and I just completed the manuscript on November 1st. The book is a practical, confidence-building guidebook for family nutrition — designed for the times of confusion about how to nourish your children.

It originally was going to be called Low Carb Kids, because of the central role ketones play in getting children off the blood sugar rollercoaster. We shifted the concept to Naturally Nourished Kids because the scope goes wider than glycemic control. There is a full chapter on blood sugar balance, 100+ low-glycemic recipes, and icons on each recipe indicating whether it’s gut-supporting, anti-inflammatory, and so on.

We have things like old-school dirt cups — made with avocado chocolate mousse and gelatin gummy worms, so kids are getting gut-restoring gelatin. Tart cherry juice for the red worms, lemon zest to boost vitamin C. Cocoa chia balls using almonds, dates, cacao powder, and cacao nibs as the “dirt.” These are fun and approachable ways to bring food as medicine into a household that might not be your typical PX Docs listener — the mainstream American family that just needs an accessible entry point.

You can find Ali Miller and the Naturally Nourished community at naturallynourishedrd.com and on Instagram. Her books The Anti-Anxiety Diet and The Anti-Anxiety Diet Cookbook are available now.

Frequently Asked Questions

What is adrenal fatigue in kids and how do I know if my child has it?

Adrenal fatigue in children occurs when the HPA axis — the hypothalamus-pituitary-adrenal stress-response system — becomes so chronically activated that the adrenal glands can no longer produce adequate cortisol and stress hormones. Signs include severe anxiety at an early age, extreme fatigue or shutdown behavior, growth delays, inability to regulate emotions, and a nervous system that no longer responds to diet, supplements, or behavioral interventions. Testing DHEA levels is a useful starting point for assessment.

Can birth interventions like induction or C-section cause adrenal problems in children?

Yes. According to Dr. Tony Ebel, induction birth, C-section birth, and assisted deliveries short-circuit the neuro-biomechanical-respiratory cascade, creating Subluxation and tension in the thoracic spine — particularly the T7–T10 region — which directly governs adrenal nerve communication. Children born this way often struggle with respiratory function, ear-nose-throat drainage, and the ability to mount and resolve immune challenges, which leads to repeated steroid and antibiotic use that further depletes the adrenals over time.

What natural supplements are most helpful for a child with adrenal burnout?

Ali Miller recommends starting with DHEA testing to assess adrenal output, then considering bovine adrenal glandular, magnesium bisglycinate (which crosses the blood-brain barrier and down-regulates the cortisol stimulus from the pituitary), targeted B6, and vitamin C at an efficacious dose — typically much higher than what’s found in a standard children’s multivitamin. Dosing must be appropriate to body weight to be effective. Always work with a practitioner for individualized assessment.

How does 4-7-8 breathing help kids with anxiety and adrenal stress?

The 4-7-8 breathwork technique — inhale for four counts, hold for seven, exhale for eight through pursed lips — activates Vagus Nerve recalibration by extending the exhale-to-inhale ratio, which pushes the Autonomic Nervous System toward parasympathetic balance. Ali Miller recommends practicing it proactively, before stressful situations arise, just as you’d train a muscle before needing it. Even a couple of cycles can produce measurable effects on heart rate and nervous system tone.

Can chiropractic care help my child’s adrenal exhaustion?

Yes, and for a specific reason. Dr. Tony Ebel identifies the T7–T10 thoracic spine as the direct viscero-somatic nerve communication zone between the spine and the adrenal glands. When a child’s nervous system is stuck in Sympathetic Dominance and adrenal burnout, Subluxation in this region creates a physical stress loop that breathwork and supplements alone cannot break. A Neurologically-Focused Chiropractic Care adjustment targeting that zone — along with clearing upper thoracic and diaphragm tension — can physically reset the adrenal-spine circuit and create the momentum needed for healing to begin.

How do I find a Neurologically-Focused Chiropractor for my child?

The PX Docs directory is the largest searchable network of pediatric chiropractors trained in the protocols discussed in this episode. You can search by location to find a practitioner near you. Find a PX Docs Office Near You

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