Diagnosing Adrenal Fatigue from a single test or symptom is very difficult. To make an accurate diagnosis, doctors and naturopaths need to look at a range of tests, sometimes conducted multiple times, and take note of every symptom. This requires experience and a thorough knowledge of the various systems in your body, as well as some patience too. It may require two or three visits to the doctor before you can be sure that you have Adrenal Fatigue.

Bioidentical hormone therapy works importantly and symbiotically with other adrenal fatigue treatment interventions to also support and balance normal sex hormone levels. Often with hormones we must come at a few of them simultaneously to achieve lasting results and regain optimal function, however it does require expertise. Additionally many botanical medicines are not safe in conjunction with conventional drugs, so it is crucial to see a licensed naturopathic doctor when using herbs as medicine.
The most common of these tests include testing bodily fluid for cortisol. Blood tests are almost never helpful in this regard, but a 24-hour salivary panel may help your doctor recognize abnormal cortisol patterns, including a lack or overload of stress response. Many doctors also test thyroid function in conjunction with cortisol levels because of the way these hormonal systems are interconnected.
A food’s glycemic index (GI) is a calculation of how much each gram of carbohydrate raises your blood glucose level. The glycemic load is an estimation of how much a certain food will raise your blood glucose level after you eat it. High GI foods (GI>70 on the glucose scale) are simple sugars that cause sudden spikes in blood sugar. Low GI foods (GI<55) are usually ‘complex’ carbs that are digested slowly and therefore have less of an effect on blood glucose levels. This means they provide sustained energy for a longer period of time. Low GI foods can include whole grains, beans, lentils and soy products. Include some low GI fruits like berries and green apples.
Some lifestyles are apparently more vulnerable to adrenal fatigue, including single parents, shift workers, an “unhappily married person”, and the “person who is all work, no play.” There’s no information provided to substantiate the quiz, qualify the vague terminology, or link to any relevant literature. (Of course there is the usual Quack Miranda warning on every page which makes all of this possible: “These statements have not been evaluated by the Food & Drug Administration … etc.”)
Also, before anyone decides to fully diagnosis themselves, first, they need to do research into the subject. I know for cortisol, if you have too much, it is bad for you as well, especially if you take a cortisol supplement and get angry with 10 mins, that means you have too much cortisol and need to level it out. You are the only person who knows what type of stress you are under on a daily basis.

I just wanted to thank Dr. Carnahan and all the staff for a wonderful visit. What a great experience from start to finish. Of course, Dr. Carnahan is the icing on the cake! (Hmmm …need a healthier analogy) Anyway, I’m feeling excited optimistic, and hopeful after all these years of being sick. Again my thanks and blessings to you all. Warmly, Roberta
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.

What can cause adrenal fatigue in someone so young? I’m in my early 20’s and I have major adrenal fatigue. I don’t have any caffeine. I never drink coffee or soft drinks. I don’t drink alcohol at all. And I don’t have a lot of stress. I do have an autoimmune disease, Hashimoto’s and I’ve read that autoimmune diseases are stressful on the body. Could it be from that? I just don’t understand and I’m really worried because adrenal fatigue can be dangerous and if I already have it severe in my 20’s, how is it going to be in my 30’s and 40’s? I just don’t know what’s causing it to where I can address it.

What is endocrinology? An endocrinologist specializes in all things relating to our hormones. Conditions affected by hormones range from thyroid problems to diabetes and insomnia. Here, we look at the endocrine system, the organs that make more than 50 hormones, why they often go wrong, and why you might want to consult an endocrinologist. Read now


Although a concept that is sometimes uncomfortable and foreign to traditional medical styles of thinking, the need for multiple interventions is required for effective treatment of such complex illnesses like CFS and adrenal fatigue. The HPA axis works as the body’s energy and hormone regulator. An imbalance between any part of the axis can affect the entire body system and treatment for such disorders requires a well-rounded approach to restore function. Therefore, adrenal and pituitary dysfunction often require treatment with several hormones. When treatment is received, individuals with devastating syndromes like CFS, adrenal fatigue and fibromylagia can “get their lives back” despite the fact that they were previously told, “there is nothing that can be done.”

Naturally, there is a good deal of advice on caring for your brain with nutrition and supplements. There are also a few sections on cortisol’s impact on health at both high and low levels of the hormone. As you might expect from someone who is an expert on neurofeedback, there is also a chapter devoted to that therapy, as well as other holistic and technology-based therapies that can help to reorient your brain to improve your natural stress response. Finally, there is a section offering insight into mitochondrial function that can help many patients to understand just how energy conversion actually happens within the body.
Eating right for one’s type of metabolism will help to ensure the proper amounts of sodium and potassium levels as well as raw materials for one’s unique biochemistry. In addition to this, understanding the regulatory effects that the sympathetic and parasympathetic nervous system has with the endocrine system is also a very important part of the picture.

Ive been to the doctor about my depression but i feel as if the doctor doesnt listen to me why I tell her I am tired ALL the time. i feel like im running a marathon just to get through the day. ive been eating healthier and going to the gym 2 to 3 days a week. nothing is helping . Lost 1 pound 🙁 im a horriible napper (i wake up in a bad mood) so i try not to nap . What should my next step be ? im stuck in this rut for now.
A: Real adrenal insufficiency describes adrenal glands that are sick and unable to function properly. Adrenal insufficiency can be caused by Addison’s disease, a pituitary disorder or another disorder. Symptoms of this life-threatening dysfunction include extreme exhaustion, lack of appetite (leading to weight loss), diarrhea, nausea and low blood pressure.
The pupil normally remains contracted in the increased light. But if you have some form of hypoadrenia [Mommypotamus note: This is the clinical term for adrenal fatigue], the pupil will not be able to hold its contraction and will dilate [open back up] despite the light shining on it. This dilation will take place within 2 minutes and will last for about 30-45 seconds before it recovers and contracts again. Time how long the dilation lasts with the second hand on the watch and record it along with the date. After you do this once, let the eye rest. If you have any difficulty doing this on yourself, do it with a friend. Have a friend shine the light across your eye while both of you watch the pupil size.
Numerous websites mention how to diagnose and treat adrenal fatigue. However, the Endocrinology Society and all the other medical specialties do not recognize this condition. The Endocrinologists are categorical: “no scientific proof exists to support adrenal fatigue as a true medical condition.” This disconnect between conventional and complementary medicine adds to the frustration.
Nutritional Deficiencies are a common cause. When under stress, the need for nutrients is much greater. Carbohydrates, when excessive in the diet, stress the adrenals. Diets low in protein may also create deficiencies. Inadequate or poor quality water affects oxygenation of the tissues. Most diets are low in nutrients required by the adrenals. These include B-complex vitamins, vitamins A, C and E, manganese, zinc, chromium, selenium and other trace elements. The reasons for this begin with how food is grown. Most food is grown on depleted soils. Processing and refining further deplete nutrients. Habits such as eating in the car or while on the run further diminish the value derived from food. Also, allergic reactions to foods such as wheat and dairy products can damage the intestines and reduce the absorption of nutrients.
I have been suffering from rocking vertigo for 7 months now with no known cause. It was brought on by a period of high anxiety/panic attacks. The feeling hasen’t left me since this happened to me in June. I have been researching adrenals as a cause because of how it started although im not seeing rocking vertigo as a normal symptom. I would say I experience fatigue too but the vertigo is the main problem.

Lately I’ve noticed that I’m dragging in the afternoon and have less patience with the potami. Though in the past I would have beat myself up for my “bad attitude” or tried to give myself a pep talk to snap out of it, this time I’m taking a different approach. I’m acknowledging that my adrenals are tired, and I’m taking steps to give them the rest they need.
You might wonder what the point of a thyroid test is, when we are looking to diagnose Adrenal Fatigue? The complexity of the human body means that one part of the endocrine system (the HPA axis) cannot exist independently of another part (the thyroid). In reality, there are connections and relationships that exist between every system in the body, and a weakness in one area can easily translate into changes in another.
Unfortunately, some types of stress are hard to spot. In his book, Adrenal Fatigue: The 21st Century Stress Syndrome, Dr. James Wilson mentions a study which measured the stress hormones of a group of nurses working in a pediatric unit. They weren’t aware of any particular stress in their lives, but their lab tests told a different story. According to Dr. Wilson, they “were totally unaware of being under stress, but their cortisol levels were elevated by 200-300%.”
The most accurate way to assess adrenal function is through a saliva cortisol and DHEA biopsy. There are other ways however to assess adrenal function, including through blood tests and through Hair Tissue Mineral Analysis. These methods won’t give you exact cortisol and DHEA values (blood tests can measure the adrenal hormones but saliva hormones are considered far greater due to the fact that saliva hormones are ‘free-fractioned’) but nonetheless they can give you insight into the 2 basic phases of adrenal imbalance: adrenal hyperfunction and adrenal hypofunction.

While not specifically about adrenal fatigue, information in this book will be an important part of your healing process. Discussing all the components of a healthy lifestyle, such as eating healthy, sleep and the physical effects of stress and stress-related illness, Dr. Schwarzbein explains not only why you are so tired all the time, but why you can't get rid of that extra belly fat. An excellent explanation of how your hormonal imbalance causes degenerative diseases and accelerated aging, this book ties together the connections between adrenaline, cortisol, insulin and other metabolic hormones, and explains how you can make changes that will prevent or reverse diseases likeType II Diabetes, high blood pressure, high cholesterol and heart disease, and how you will lose weight as a result of healing your metabolism, and why it won't work to try to lose the weight BEFORE you get your hormones under control. This book outlines 4 different plans for recovery, depending on your current metabolic condition:

The most accurate way to assess adrenal function is through a saliva cortisol and DHEA biopsy. There are other ways however to assess adrenal function, including through blood tests and through Hair Tissue Mineral Analysis. These methods won’t give you exact cortisol and DHEA values (blood tests can measure the adrenal hormones but saliva hormones are considered far greater due to the fact that saliva hormones are ‘free-fractioned’) but nonetheless they can give you insight into the 2 basic phases of adrenal imbalance: adrenal hyperfunction and adrenal hypofunction.
If you think you may have a medical emergency, call your healthcare provider or 911 immediately. Any mention of products or services is not meant as a guarantee, endorsement, or recommendation of the products, services, or companies. Reliance on any information provided is solely at your own risk. Please discuss any options with your healthcare provider.
Dr. Wilson also delves into the types of people and personalities who are commonly afflicted with this syndrome. He explains how different professions can leave certain people vulnerable to the type of stress that can overload their adrenals and result in this syndrome. Included also are examinations of how certain diseases have an adrenal component that can lead to adrenal exhaustion.

These symptoms are mostly related to the changing hormone and neurotransmitter levels that come with Adrenal Fatigue. There are a number of other, less common, symptoms that can also appear. These might include vertical lines on the fingertips, frequent urination, and low blood pressure. Again, these are all related to the dysregulation of the HPA axis and the various hormone levels that depend on it.
Kathryn Simpson‘s 2011 book, Overcoming Adrenal Fatigue: How to Restore Hormonal Balance and Feel Renewed, Energized, and Stress Free, carries with it the experiences and advice of someone who has suffered adrenal fatigue (and multiple sclerosis), fought against its effects, and secured the victory that only comes with full recovery. Today, she continues her efforts to share her story and the lessons she learned with other patients in similar situations, even as she works to further the scientific community’s understanding of hormones.

While adrenal fatigue may not exist, the same can’t be said for the treatments. When you’re treating a fake disease, anything goes. Everything from homeopathy to herbal remedies to hydrotherapy, to traditional Chinese medicine and vitamin supplements are advocated for treatment. The endpoints of treatment are as nonspecific as the criteria for diagnosis. Wilson, conveniently, has his own supplement programs, and there’s no shortage of solutions out there.


The adrenal glands (also known as suprarenal glands) sit atop the kidneys and are chiefly responsible for regulating the body’s stress response through the synthesis of corticosteroids and catecholamines, including cortisol and adrenaline. In other words, the task of your adrenal glands is to rush all your body’s resources into “fight or flight” mode by increasing production of adrenaline and other hormones. When healthy, your adrenals can instantly increase your heart rate and blood pressure, release your energy stores for immediate use, slow your digestion and other secondary functions, and sharpen your senses.

The book includes a number of questionnaires – self-evaluations that can help you determine the nature of your exhaustion – as well as treatment protocols and other sound advice that can help you to nurse yourself back to health. Many have compared Simpson’s approach to this ailment to that advocated by Dr. James Wilson in his seminal work on adrenal fatigue, Adrenal Fatigue: the 21st Century Stress Syndrome. For many patients, however, her work may be even more accessible, as it is 200 pages shorter than that important treatise. That fact - along with its clear and understandable approach to the subject - makes it a nice addition to any reader’s collection of fatigue recovery books.

I've been disabled now for almost 10 years, but before that, I worked as an RN, BSN (with a certification in Infection Prevention) for over 30 years. I got my Bachelors in Nursing at a well-known University. Unfortunately, we, as students and as nurses, were indoctrinated with the belief that ONLY WESTERN ALLOPATHIC medicine was valid, and complementary and natural health were quacks. Some are, as well as some Western medicine doctors. It took me many many years to realize that our western medicine's practice of lab and radiological and other testings' means of diagnoses, followed by prescription medication as treatment, dictated by protocols and insurance companies, was doing more harm sometimes than good. I started believing in nutritional and natural means of helping my body heal itself was far better than medications in 2013. However, by that time, I was taking 10 prescription medications twice a day. In the beginning of 2016 I became so fatigued, I would fall back to sleep an hour after I slept 9 hours. I had SEVERE sleep apnea. I went to see an Endocrinologist, and ALL my results for Adrenal Insufficiency (Addison's Disease) were there- undetectable cortisol levels, undetectable epinephrine and norepinephrine in my 24-urine collections and blood tests. However, at the test that is called "The Gold Standard" for Addison's, my cortisol level went up 3 times the baseline after an injection of synthetic meds. So even with all these other abnormal tests and my overwhelming fatigue, I was told I didn't have Addison's and should come back for repeat tests in 6 months. If I sound angry, I am. I found an article on Wikipedia that said if your cortisol level goes up 3 times after that test, it indicates a pituitary or hypothalamus problem. The doctor "didn't think I had those issues". So, if YOU ARE LIKE ME, and you KNOW something is not right with you, and medical doctors ignore you, tell you it's all in your head, or you should just RELAX, READ THIS BOOK and others like it that deal with natural alternative healing. Use common sense in deciding what to try in helping your body recover health, but PLEASE TRY TO HELP YOURSELF and not totally rely on doctors who only give out pills, pills, and more pills. In fact, Dr. Wilson (who is NOT an MD, but is highly trained) writes a very vivid account of what western medicine has degenerated to right now. It is startling, and as an RN who worked in Quality and Risk, I know he is correct. Adrenal Fatigue is an epidemic today in the USA, where we live stressful lives and have stressful jobs. There is a test in the book that has been used to "diagnose" your tendency to have adrenal fatigue. And Dr. Wilson gives step by step actions we can take to "get our lives back", using nutrition, supplements, activities, and other natural remedies. He also tells about a simple saliva test for adrenal insufficiency or fatigue that the medical community refuses to accept. If you are sick and tired of being sick and tired, PLEASE CONSIDER buying and reading this book. If your doctor refuses to believe you are not well, help yourselves. Thank you for putting up with me if you read through this Long Review!!
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.)
I’m currently taking a supplement that contains bovine adrenals and bovine spleen. I have adrenal fatigue, IBS, and insomnia, and my naturopath follows the four pillars of world cuisine plan. Is it dangerous to takes glandular supplements? The product is from Standard Process and they are very reputable. Still, I have my concerns. Should I trust my naturopath on this?

Pick begins by covering a number of important topics: the nature of adrenal dysfunction, the effects of chronic stress, and how you can identify your own “adrenal profile.” From there she moves on to solutions that encompass a thirty-day period of concerted recovery efforts. That plan includes dietary changes, supplement advice, exercise, and a focus on the emotions that is often lacking in other books. There’s even a complete 30-day eating plan with recipe ideas. The book then addresses life after recovery, and attaches a number of reference guides, resources, and an index at the end.
Interpreting the results correctly can be difficult for a physician without experience of Adrenal Fatigue. The reference ranges supplied by labs are so wide that they only flag up extremely low cortisol levels. So your doctor will need to look at the levels provided and make his or her own judgment. This is where the importance of using an optimal range, rather than the reference range, becomes clear.

This is a doctor who specializes in both Western and Eastern medicine and thus combines a holistic approach with potential medications. I believe that this type of physician is best equipped to handle adrenal fatigue. You can also consider a functional medicine physician, which is a doctor trained to look at the body as a whole with an emphasis on searching for the underlying cause of your health deterioration rather than the symptoms.


I don’t know someone out there, I’m on the east coast. However have you heard of a company called Inspired Nutrition. I’ve used the Ultimate Monolaurin, Skin defense, Silver Skin and C-A-Y defence and they worked great for my needs. The Ultimate Monolaurin is great product that benefits so many disorders and illnesses. Research Monolaurin on the Internet to see all that it can help. It works really well. It might be a great additive to what your taking. Also email me privately, my sister inlaw is in Seattle and I have a friend who is a chiropractor in CA, they might know of someone your way. Lcole0712@gmail.com. send me exactly where you are, what your looking for and what’s going on and I will run it by both of them. I wish you the best in you journey to Great Health! Lorena
While adrenal fatigue is not accepted by most doctors, adrenal insufficiency is a real medical condition that occurs when our adrenal glands cannot produce enough hormones. Adrenal insufficiency is caused by damage to the adrenal glands or a problem with the pituitary gland—a pea-sized gland in the brain that tells the adrenals to produce cortisol.
What type of specialist (i.e., doctor, naturopath, etc.) is the most effective to help with this treatment? I have had thyroid issues since my 20s (I’m now in my 50s), including the periodic loss of hair in large spots on my head, weight gain (now to include the lovely layer of fat around my midsection), exhaustion after workouts, and on and on. I have also been told I have adrenal exhaustion. I would really appreciate some guidance.
It wouldn’t surprise me if almost everyone has adrenal fatigue in the day and age we live in. There’s different “levels” and/or severities of adrenal fatigue. I have had professional help in my diaginosis for adrenal fatigue by going to a naturopath doctor and I HIGHLY recommend Dr. Wilson’s book and supplements. They have put me on the road of recovery and I am so thankful. I was so sick with anxiety and insomnia that I had two separate times about 2 months apart where I was literally in bed for a week – which was horrible being a mom of 3 very young children. Thank God for my husband and family – I wouldn’t have been able to recover without their help and support! And thank God for Dr. Wilson!
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.

Hi Jill! I feel like I have just found gold after reading your site about adrenal fatigue. I have been doing so much testing the last year and a half as endocrinologist has been concerned about my symptoms. After the onset on some very serious stress 4 years ago I started noticing light headedness throughout day esp upon rising, crawling sensation across back and what I would call back spasms at my rhomboids that would make it difficult to breath, itching in the location, of what I know now are the adrenals, hair loss, fatigue around 3 every morning, up late at night , hard to rise or even have a functioning brain til at least 10, test resulting in inflammation, increased blood pressure (being managed), irritable bowel, Random weight gain, then lost and now sudden weight gain again and on and on and on. Every single symptom you listed. Just saw derm (referred by endocrinologist) and she said I have paresthesia. I am so thankful you have posted this information in the easiest way to understand as Ive been so concerned with what has been going on in my body and just to know that I may have an answer is such a relief (I think). I have recently started upping my vitamins worries I was deficient including ashwaganda, and starting rhodiola. I am very concerned about damage that has been done over these few years and want to immediately try to fix this. How can this affect my organs and health? And has there been remarkable damage to my body? I just was ordered to take a calcium screening and heart was great, lungs great etc. just worried. I will start following you advice and hope to get back to normal. Thank you, thank you for your education and advice.


Hello, It all started about 8 months ago when my symptoms first started appearing. My first symptom was unexplained paresthesia through my body, usually around the neck area and extremities. After a while, it got the point where my legs would start hurting (burning sensation) on the inside after standing up for a while. After driving home from work at night, I felt wired, as if I had consumed 2-3 cups of black coffee in one sitting. I had to leave my job because of this. There was a period in where these symptoms were beginning to subside but gradually came back so I also stopped exercising and lifting. In the past 5-6 months I have changed my diet drastically, experimenting with different things such as gluten-free paleo, vegan, and even raw foodist at some point. My symptoms remain the same. I constantly battle with fatigue, I have trouble waking up in the morning(cold hands and feet and shivers upon waking up), extremely low libido, loose stool, and brain fog. I have an appointment tomorrow with an endocrinologist but would like to hear from you first. What can I do in the meanwhile to alleviate these symptoms? What might be the root cause of all this? Thank you!
Testing can be an important part of the process. The patients have often been given saliva tests for cortisol, so Nieman tells her patients that saliva tests are not considered reliable. She explains that the standard test is the corticotropin (ACTH) stimulation test — and that if the adrenal glands can respond to the stimulation by releasing cortisol, it disproves that theory that the glands are burned out.
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