Dr. Will Cole, leading functional-medicine expert, consults people around the world via webcam at www.drwillcole.com and locally in Pittsburgh. He specializes in clinically investigating underlying factors of chronic disease and customizing health programs for thyroid issues, autoimmune conditions, hormonal dysfunctions, digestive disorders, and brain problems.Dr. Cole was named one of the top 50 functional-medicine and integrative doctors in the nation and is the author of Ketotarian in which he melds the powerful benefits of the ketogenic and plant-based diets.

I have had anxiety/panic attacks for years and recently been through a lot of stress and have developed low blood pressure, dizziness and increased heart rate especially when walking around, and weakness, and sometimes episodes of dizziness where my blood pressure is high. I’m pretty sure this is adrenal insufficiency and I started taking 5,000mg vitamin C and started with 1tsp sole water and multi vitamin, and adrenal response supplement. I also follow a gluten free, soy free, dairy free with the exception of goat cheese. Is there anything else I can do to help?
Food is medicine. I always ate healthy, other than my favorite "healthy junk foods" of gluten-free pizza and stevia soda. But I knew that if I was going to rehab my adrenal fatigue, I had to take my food medicine plan to the next level. I had to make sure my diet was on point for hormone health. Here's the 90-day food plan I used to improve my sleep and energy.
One of the hallmarks of alternative medicine is the “fake disease”. Fake diseases don’t actually exist – they are invented without any objective evidence showing that they are real. Fake diseases tend to emerge from vague symptoms which can’t be attributed to a specific medical diagnosis. This is not to say what patients are experiencing isn’t real – the issue is the diagnosis, and the practitioner making the call. As has been pointed out by other SBM contributors, it’s understandable to want reasons and answers when you have debilitating symptoms. But symptoms need to be studied in rational and objective ways in order to understand the underlying illness – call it the “root cause” if you prefer. The diagnosis guides the treatment plan, so getting a diagnosis right is essential. While a group of vague symptoms might lead a medical doctor to run tests to rule out serious illness, alternative medicine providers seem to jump to the diagnosis and techniques they prefer, even if they’re completely unvalidated, or made up out of thin air. It’s your Chi. Your energy fields. It’s wifi. It’s gluten. In this case, it’s your adrenals. Rather than offer a guide to proper care, a fake disease is a distraction from the truth.

"You don’t know how much I appreciate your new book, The Adrenal Fatigue Solution. I have been undergoing unrelenting stress for 7 years. I haven’t understood why I cry, have so little energy, and am irritable all the time. Now I do, and I know how to cope. Your selfless efforts in gathering this book’s information are so generous. Thank you and God bless you. I love you for your help."
To address some above comments, in having tested quite a few people this year in NTP school, I find most people’s pupils pulse (release, contract, release, contract, rather quickly), rather than completely releasing for a prolonged period of time. What you’re looking for is a sustained, non-pulsing contraction for 30 seconds. The longer the sustained contraction, the better. Pulsing is better than fully releasing, and some people don’t contract at all, which would be a big indicator.
Because of the vast influence of the adrenals on the body, symptoms of adrenal fatigue can mimic a number of disorders and isn’t always easily recognizable. Most sources agree that adrenal fatigue symptoms include extreme fatigue, brain fog, weight gain, insulin resistance and others (more on that below). While the mere fact you feel fatigued is not necessarily indicative of adrenal fatigue, and adrenal fatigue tests aren’t always straightforward, there is evidence that high cortisol levels found in saliva are associated with reduced immune function, increased blood pressure, increased heart rate and delayed growth in children. (1)
Hi there! I am so glad that you are discussing this important topic. I suffered from adrenal fatigue for years (unknowingly), which in turn blessed me with premature brain degeneration at the tender age of 31. I was lucky to had found the right holistic doctor (his name is Steve Tashiro, and he is located in Denver, CO), who diagnosed me and enabled my healing. It took a long time to get to him – in the meantime I had been recommended lithium (for symptoms of bipolar disorder), sent home “to relax,” told to find a husband, and even named a hypochondriac by a reputable NYC doctor (!?). If you feel tired allllll the time, chances are more than great that your adrenals are off the wall. Get a doctor, GET THE RIGHT SUPPLEMENTS (company named Apex produces Adaptocrine, a supplement creates to support adrenal function, for example), and be ready to handle a very strict diet. It is so worth it in the end.
When a threat happens, your sympathetic nervous system stops digesting your food, it stops worrying about producing babies so your reproduction stops and it takes away the priority from worrying about your immune system and your thyroid (because your body thinks it’s in survival fight/flight mode getting chased by a tiger) and your blood rushes out of those areas and into your legs and arms so that you can flee from the tiger your body thinks is chasing you. Your sympathetic nervous system was deigned to deal with physical challenges, so that’s why this reaction occurs. So, what is really happening is that your body doesn’t care about the long-term focus of your health right now. It’s focused on how to keep you alive right now in this moment through the fight/flight mode. THIS is called the stress response (fight/flight mode). Your blood pressure increases, your palms sweat and you feel pumped up and ready to fight or flee from danger. Sound familiar?
If you have tiredness, brain fog, lack of motivation, among other symptoms, you should first have a thorough evaluation with a medical doctor. Anemia, sleep apnea, autoimmune diseases, infections, other hormonal impairments, mental illnesses, heart and lung problems, and kidney and liver diseases are just some among many medical conditions that could cause similar symptoms. If the workup from your medical professional turns out normal and you believe you might have adrenal fatigue, I would recommend you consider a fundamental question: Why would your adrenals be drained? Take a better look at what types of stress might be affecting you. For many, the hectic pace of modern life is to blame.

It is ordinary for stress to cause cortisol levels to rise in a normal fashion, but in adrenal fatigue the output of cortisol and other adrenal hormones is constantly being stimulated. This overstimulation causes the body’s vitality to dwindle. With each downshift in adrenal function, the body is considerably more affected in a negative fashion: “adrenal fatigue, in all its mild and severe forms, is usually caused by some form of stress…. It is important to know that your adrenals respond to every kind of stress the same, whatever the source” (p 11). Cortisol is a powerful hormone that has a profound effect on every organ and system in the body.
To that, all I can say is that adrenal fatigue is something I’ve seen personally. It is my opinion, through years of healthcare practice and supporting scientific evidence, that hypoadrenia is very real and associated with a number of complications. In addition, adrenal fatigue treatment is relatively non-invasive and is beneficial to your health, no matter the diagnosis. Of course, you should be under the care of a qualified medical professional, such as a functional medicine doctor, you trust and see them about any symptoms you experience (of any disease) so that they can determine appropriate treatment.
I now try to avoid caffeine in the afternoon. This is difficult, as I am a self-admitted tea addict, but I opt for the caffeine-free chamomile or rooibos instead if it’s after lunch. Other ways to promote quality sleep include turning off the TV, computer, and smartphone a few hours before bed (those screens and artificial light can overstimulate the brain, block melatonin production, and negatively impact sleep quality), and eating an ounce or two of clean protein like organic turkey, along with 2 tablespoons of coconut oil right before bed. This has a balancing effect on blood sugar throughout the night.
Adrenal Fatigue Syndrome - Reclaim Your Energy and Vitality with Clinically Proven Natural Programs, by Dr. Michael Lam, is a reference guide that packs virtually every bit of information you ever wanted to know about adrenal fatigue into its massive 500-page frame. Dr. Lam has been a pioneer in the study of adrenal-related issues, and personally provides help for millions on his own website, drlam.com.
For example, if an individual suffering from Adrenal Fatigue continues to eat junk food, declines to exercise properly (or over-exercises) and does not take the appropriate supplements, his treatment will inevitably require more time. On the other hand, an individual who follows all the recommendations of his healthcare professional can expect a much faster and better outcome.
Because so much of adrenal fatigue is really brain-based, most of the natural medicines I use focus on supporting optimal brain health and the brain’s response to stress. Explore blends of adaptogenic herbs like ashwagandha, eleuthero ginseng, holy basil, and rhodiola rosea to give your adrenal axis some TLC. I also incorporated phosphatidylserine supplements into my routine. (Of course, consult your doctor before implementing any herbs or supplements.)
If you’re healthy, your body will fall back into the relaxed state it was in before the threat and your body calms down. Everything shifts back to helping you digest, etc and your thyroid and reproductive organs go back to work. This relaxation response is spear headed by your parasympathetic nervous system, the other part of your autonomic nervous system. If you’re like many people, your stress will be high at work and your sympathetic nervous system will be in full gear helping you tackle everything that comes your way, then you shift into the parasympathetic nervous system at night when you’re with your lover or family or children and you can relax, watch TV, read, eat a nice dinner, cuddle, get ready for bed and perhaps have sex. All of which are quite relaxing to your nervous system. This is ideal.
Is this a book or a website? Best Boo-Boo Kisser South Of Puckett’s Gas Station. I’ve found that foot zoning and body code have helped me a lot in recovering from unhappy adrenals, thyroid, and liver. The foot zoning helps teach the body how to heal itself and releases trapped emotions. The body code finds the imbalances and rebalances them while releasing the trapping emotions. I think red raspberry leaf tea or is it peppermint tea that helps with adrenal function. I’m wondering if my pillow is off gasing and making it harder to get a good night sleep. There’s gotta be a healthy pillow that provides good support without being noisy like the buckwheats pillows.
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This syndrome develops due to the malfunction of the adrenal glands in producing hormone competently. The adrenal gland secretes cortisol which is a hormone essential to optimal health. Cortisol in the body in excessive amounts may lead to problems that are severe such as Cushing’s syndrome. But, if released in amounts that are common by the gland, cortisol is a hormone that is vital to helping the body fight infection and deal with stress – without cortisol the body is not able to sustain life. Balance is crucial as well. Cortisol has an effect on every tissue, gland and organ in the body. When these glands are tired, they don’t provide the body with adequate cortisol. The body does what is necessary to get by but it is not without penalties. As such, this syndrome normally precedes other chronic situations.
Primary adrenal insufficiency is what is known as Addison’s disease and occurs when the adrenal glands are damaged by some type of trauma and can’t produce enough cortisol or aldosterone. The much more common type of adrenal insufficiency is known as secondary adrenal insufficiency and occurs when the pituitary gland stops producing adenocorticotropin (ACTH). ACTH is what stimulates the adrenal glands to produce cortisol, so it stops this process from moving along. (39)
Debi please look up General Adaptation Syndrome. Back in 1936 it was entered into the medical literature and encompasses what the chiropractor tried to define and then some – there was no need to reinvent the wheel, but sadly the work is no longer well known. The man (Dr Hans Selye) who did the studies and defined the syndrome also appropriated the word “stress” from physics and it entered into medical vernacular as a result. Most of what we know of the stress response and the effects of stress is based upon the foundation of his work (as is our understanding of adrenal hormones). The bottom line is that by whatever name, adrenal insufficiency is real, it’s been very well defined and mapped and virtually undisputed since 1936, just not called by its proper medical name: General Adaptation Syndrome. It’s a syndrome because it’s a cluster of symptoms; it’s not a disease as is Addison’s.
I had my saliva tests done, and the results showed that my cortisol level wouldn’t even register a number after 11am, dipped further off the grid at 4pm and a slight surge at 11pm. Understanding the inverse relationship with DHEA, that level was “off the chart high”. I’ve been on Adreneltone and cortisol manager supplement for almost 3 months and the fatigue only seems to be the same if not a little worse (I actually fell asleep during my daughters dance competition! )

Of course, that money trail is only part of the story. While the lack of patentable treatments for adrenal fatigue is a prime reason for medical science’s failure to recognize it (the pharmaceutical companies have no interest in conditions that offer no real possibility for profitability) there is also the issue of the restrictions placed on doctors by licensing boards and insurance companies. Today’s doctors are simply much more conventional and conservative in their approach to medicine, and rely on consensus rather than their own experience and knowledge. Laboratory results and tests are now the mainstay for almost all forms of diagnosis, and adrenal fatigue is notoriously elusive when it comes to those tests.


According to the Mayo Clinic, severe adrenal fatigue symptoms may actually be Addison’s disease. This disease occurs when your adrenal glands stop producing sufficient amounts of cortisol permanently, due to autoimmune disease or damage to the adrenal glands or pituitary glands. Unlike adrenal fatigue, Addison’s disease is marked by unexplained weight loss, rather than gain. The Mayo Clinic urges anyone with symptoms such as hyperpigmentation (darkening of skin), severe fatigue, unexplained weight loss, major gastrointestinal issues, lightheadedness/fainting, salt cravings and muscle or joint pain to see a physician immediately.
The book is divided into 4 parts that are arranged sequentially so that each section prepares the reader for the successive readings. Part 1 is an overview, including the causes of adrenal fatigue, while part 2 segues to self-help assessment tools, including a questionnaire designed to help readers determine if they are experiencing adrenal fatigue. Part 3 provides an extensive guide focused on recovery from adrenal fatigue, while part 4 presents a reference section on the role of the adrenal glands.
Dr. Smith will likely order blood work, but in some cases salivary cortisol levels taken at four different times over the course of the day (a kit you take home) is a better option for a more detailed survey of adrenal function. Usually Dr. Smith will also assess some other adrenal hormones in her lab work such as DHEA. Both blood and salivary tests are equally sensitive when testing cortisol levels.
Hey girls, I too am in the same boat at you. I am 49 and sure I have been Perimenopausal for several years. This year has been the worst. I am one giant hot flash 24/7, heat Palps, panic attacks, missing periods, edema all over, hair falling out (all comprehensive thyroid tests are normal), depression, out of control weight gain even from eating almost nothing, horrible sleep, digestive problems, gas and bloating all day, choaking on mucus 24/7 despite eating gluten-free, dairy-free and sugar-free, Lyme disease, bad, I mean really bad adrenal fatigue which worsened after my mom’s death two years ago, pain all over the body, severe fatigue, and about 30 other symptoms. I have been sick for over 20 years with Lyme, Epstein-Barr, mycoplasma, mold toxicity, Candida, hidden bio-unavailable copper toxicity, a clotting disorder from the Lyme, and sporadic HHV-6 and Cytomegalovirus, with no help. I live in Southern California. If anyone knows of a naturopath or integrative medical doctor who measures up to Dr. Northrop’s calibur, please, please email me angelofeventide@yahoo.com. Thanks so much.
A start is leading a more holistic lifestyle overall, stay away from processed and refined foods, eat/drink fermented foods, get the sleep you need listen to your body and yourself and not others, there are so many out there that will offer advice much of it contradictory, go slow develop a new life style not just a temporary change. if you have the money go to a holistic or alternative medicine, or a doctor who believes in complementary medicine. beware of those who stand to gain financially from your problems.

Thank you for the wealth of knowledge you share in your blogs and follow-up comments. What stage of adrenal/HPA-axis dysregulation would you consider a patient with the following results? Symptoms are consistent with abnormal cortisol levels and hypothyroidism; current treatment protocol from primary includes Armour thyroid 30mg. Could Hashimoto’s (or autoimmunity) be a possible cause? Or are lifestyle factors (sleep, glucose regulation and diet, stress, etc.) more likely for the following patterns?


Sugar and sweeteners: Includes avoiding high-fructose corn syrup and artificial sweeteners as well. Avoid sugary foods, cereals, candy, sweets, etc. Be aware that sugar is an additive in many breads, condiments and dressings. Try to avoid as much extra sugar as possible. Seek the benefits of raw honey or stevia as an alternative, and always moderate your use of sweeteners of any kind.
I have been suffering since two years, due to I guess too much exercise and less carbs. I have the following symptoms, bad sleep, dehydrated and no thirst feeling, thinning hair, cold feet, dandruff, low libido, very bad digestive system almost always bloated, but the most important thing is, there is liquid coming out of my anus. In short, I feel extremely bad during the day.
Fish oil (EPA/DHA): There are a large number of benefits of supplementing with fish oil (or, for people on vegan or other plant-based diets, algal oil). Several of these include counteracting a number of adrenal fatigue-related symptoms and complications, such as diabetes, mental dysfunction, arthritis, immune system function, skin issues, weight gain and anxiety/depression.
One of the most commonly overlooked causes of Adrenal Fatigue is intestinal infections that gives rise to an inflammatory response. Such infection can occur sub-clinically with no obvious signs at all. Infections in the gut, including giardia, SIBO (small intestinal bacterial overgrowth), fungal dysbiosis, and h. pylori infection are just a few that may contribute to adrenal dysfunction.
Adrenal hypofunction indicates an insufficient amount of cortisol and adrenal activity, exactly the opposite of adrenal hyperfunction. in adrenal hypofunction there is an excess in the amount of mineralcorticoids in the blood. This causes an increase in the amount of potassium in the cells and blood, and a decrease in the amount of sodium in the blood. Adrenal hypofunction, sometimes referred to as adrenal burnout, can result in chronic fatigue, exhaustion after exercise, abnormal fluid dynamics, low blood pressure and hypothyroid function.

Adrenal Fatigue Syndrome is a very real condition, but navigating your way through all the treatment options can be difficult. Individuals with Adrenal Fatigue tend to bounce between family doctors, endocrinologists, psychotherapists and more. They are often prescribed drugs like sleeping pills and antidepressants by well-meaning doctors who simply can't figure out what is wrong with them. But the truth is that treating Adrenal Fatigue involves much more than prescribing drugs. It requires a combination of experience and knowledge of both conventional and alternative medicine.
One of the most difficult aspects of adrenal fatigue is the fact that medical science continues to avoid the subject. Despite their inability to diagnose many cases of extreme exhaustion without referencing adrenal function, there are many doctors who still stubbornly refuse to acknowledge the existence of this problem. That leaves patients with little choice other than to manage their own recovery program. The good news is that there is a wealth of information to be found in the many books on adrenal fatigue in the marketplace today.
So during my healing journey, I started practicing mindfulness meditation and other strategies to bring mindfulness into my day. Even just taking some time throughout the day to become aware of your breath is a simple way to defuse stress levels and calm your brain-adrenal axis. I'm also a big fan of listening to Eckhart Tolle audiobooks when I'm in the car.
This book was very informative and a very practical guide for people wanting to take action to improve the condition of adrenal fatigue. Very helpful about other related health conditions. Covered every aspect from a very good self assessment, explanation and impact of the condition, and the ways in which people can make changes to assist themselves. My health has certainly improved since applying the principles and practical help.
The adrenal glands, which sit on top of your kidneys like little kidney baseball caps, release several important hormones one of which is cortisol. Cortisol is one of your primary stress-related hormones and regulates your energy. Normally, it rises in the morning to help you wake up, then slowly goes down throughout the day, sinking at night so you can sleep well. Cortisol also helps regulate your blood sugar and pressure.
Easy for the non-scientist to understand. Lots of obvious information, like sleep more and eat better. I used this book more for the supplements chapter. I increased my bit C and B6. I stopped taking DHEA because of this book (not recommended for women) and started taking pregnelone instead. Some stuff I didn't know is that salt is good for you and bananas are bad for you if you have adrenal fatigue.
Thank you for sharing your recovery process for your adrenals! This spring I began the journey to find remove things from my diet that irritated my adrenals, causing them to ‘crash’. In my search for healing, I found your article and it’s so encouraging! I do have a few questions though…. is the reason for fat bombs to give the adrenals rest from needing to help create energy (by eating ‘sugar’ multiple times an hour? and after they’re back to normal, the fat bombs won’t be necessary?

I think adrenal fatigue is real and could be the symptom of other illnesses. When your cortisol level is low for whatever reasons your blood pressure is bound to be low resulting in lethargy and general weakness. People who complain of tiredness should be checked thoroughly by endocrinologists to ensure that they are not suffering from serious illnesses such as Addison ‘s disease for example.
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