After a while, though, he started putting on a lot of weight – close to thirty pounds, actually. He has experience significant fluid retention, and his blood sugar was getting unstable (heading towards diabetes). But whenever he stopped or lowered the dose, his energy simply plummeted, worse than ever before. He was in a bind, and that is when he came to see us.
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The skin darkening that concerns endocrinologists most often occurs in Addison’s disease, but not secondary adrenal insufficiency. The latter of these conditions is often not diagnosed quickly because people ignore symptoms until they are drastically obvious. People with adrenal insufficiency do experience severe fatigue, often not reflected by salivary cortisol levels. (40)

I also promote quality sleep by turning off the TV, computer, and smartphone a few hours before bed (they can overstimulate the brain, block melatonin production, and hurt your quality of sleep). And I often eat an ounce or two of clean protein like organic turkey and 2 tablespoons of coconut oil before bed to balance out my blood sugar throughout the night.

In a healthy person, your cortisol is high in the morning, which wakes you up and then the cortisol levels start to decrease throughout the day and into the night until they’re so low that you fall asleep. Now, when you’ve got adrenal fatigue, like I had for probably about 30 years (yes the majority of my life)–I’m only 34, you could wake up feeling like you got hit by a car and you have to drag yourself through your day. Then bedtime comes and you’re wired and can’t fall asleep and you have insomnia. Sound like you? There are millions of people dealing with this and Western M.D.’s do not address Adrenal Fatigue Treatment so it’s really sad to know that so many people are not getting the help they need. When I had adrenal fatigue, I felt depleted and wired and on edge and by body was so out of whack. It was awful.

I read about adrenal fatigue in another book and as they described the syndrome I was baffled because I thought they were describing normal every day life. The idea that it might be possible for me to have a day where I was not tired and cloudy headed definitely peaked my interest. This book was fascinating to me because it explained what causes these kinds of symptoms and what it would take to put things back in balance. The regimen of supplements suggested by this book was overwhelming and jus ...more
The light should cause your iris to contract, making your pupils (the dark spot in the center of your eye) smaller.  Normally, they should stay that way, but if you have adrenal gland fatigue, the iris will be weak and will not be able to hold the contraction, it will either waver between contracted and relaxed, or will contract initially, but then open up after 10-30 seconds.
Conventional blood tests, taken at whatever time your doctor has scheduled your appointment, might indicate that your adrenals are normal. However, a better diagnostic approach will test your levels at different times of the day, which is much more likely to reveal an out-of-whack pattern of cortisol or DHEA secretion. Adrenal fatigue is characterized by cortisol levels that are too high at night and not high enough in the morning.
Interesting article. I was diagnosed by my MD (endocrinologist) with Adrenal Insufficiency about 18 months ago. I am also a type 1 diabetic with other high-risk chronic diseases. He put me on a low dose of Cortisol twice a day. I have been hospitalized in ICU due to Adrenal Failure, which can be fatal if not treated. If you suspect adrenal issues, see your doctor.
“Our role is to be good active listeners to determine if there is a true medical disorder lurking among the complaints. It is very important to take the person seriously, not to brush them off and say there is no [such thing as] adrenal fatigue. These people are suffering from something, so we need to take the suffering seriously.” – Lynnette Nieman, MD, president, Endocrine Society; senior investigator, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md.

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.


One particular question I have is, can large amounts of coffee skew the results of a cortisol saliva test? My doctor wanted me to do what I normally do in a day and the results were normal, but journal for me is 3-5 of extremely strong black coffee a day ( my most awake moments are about an 1 hour long after each cup, expect the one at the end of the night and then I crash hard). The fatigue has gotten do bad that I’m crash after doing the simplest things like cooking for my family.

One particular question I have is, can large amounts of coffee skew the results of a cortisol saliva test? My doctor wanted me to do what I normally do in a day and the results were normal, but journal for me is 3-5 of extremely strong black coffee a day ( my most awake moments are about an 1 hour long after each cup, expect the one at the end of the night and then I crash hard). The fatigue has gotten do bad that I’m crash after doing the simplest things like cooking for my family.

A saliva cortisol test is taken at home using a simple kit. Basically, you spit into a vial several times a day, then send the samples in for analysis. The lab will review how your cortisol levels ebb and flow. I’ll explain more in future posts, but for now what you need to know is that an abnormal pattern suggests HPA axis dysfunction, which suggests adrenal dysfunction. (HPA stands for hypothalamic-pituitary-adrenal.)

Unfortunately, the adrenal glands' health is paradoxical. As the manufacturer of adrenaline, they are the "glands of stress," but are also the first glands to fail during prolonged or intense periods of stress. The problem with stressors is that they are "cumulative," in the sense that their impact tends to add up in the body over time until your adrenal glands (and probably your mental state) just can't take anymore. "One more stress is the stress that breaks the camel's back," Dr. Wilson says.


Conventional medicine will detect only the extremes of these conditions, when damage to the adrenals has already occurred (Cushing’s disease and Addison’s disease). Within those extremes, you can feel miserable and still be told your cortisol levels are normal. But by responding to early-stage symptoms of adrenal fatigue, we can reverse the developing dysfunction.

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