Regardless of what we call it, there are millions of people suffering from similar symptoms, and a personalized plan that involves counseling, medications, supplements, lifestyle change, among others could work for many. Improvement following these programs is slow, and the evidence is weak, but I hope advances in big data, genomics, and its relationship with the environment and the microbiome, may shine a light on how to better help people who suffer from these ailments.
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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.)

Doctors urge you not to waste precious time accepting an unproven diagnosis such as “adrenal fatigue” if you feel tired, weak, or depressed. If you have these symptoms, you may have adrenal insufficiency, depression, obstructive sleep apnea, or other health problems. Getting a real diagnosis is very important to help you feel better and overcome your health problem.
The DUTCH testing is the only one I use because with other salivary testing you will not see the true picture (more here https://dutchtest.com/2016/07/05/adrenal-fatigue-is-all-in-your-head-sort-of/) About 30% of people with low free cortisol overall, have elevated levels of metabolized cortisol. Think about the implications of that. When you see low overall free cortisol in saliva (or in urine) you THINK cortisol production is low. In almost one out of three patients, they are actually making more cortisol than 80% of their peers. They make lots of cortisol! You just can’t see it in the free cortisol.
Those with adrenal insufficiency may suffer an adrenal crisis if symptoms of adrenal disease are ignored. An adrenal crisis (known sometimes as an Addisonian crisis in those with Addison’s disease) is marked by symptoms like severe, sudden pain in the legs, back or abdomen, severe vomiting/diarrhea, dehydration, low blood pressure and loss of consciousness.
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.
Dr. Eric Wood is a licensed Naturopathic doctor with extensive clinical and teaching experience. He graduated from the Canadian College of Naturopathic Medicine with additional post graduate studies at the Benson Henry Institute of Mind Body Medicine at Harvard. Dr. Wood has worked in both private practice and consulting work, with experience in many different areas of Integrative and Mind Body Medicine. He has specialty training and expertise in the areas of oncology, infectious disease, Adrenal Fatigue and anti-aging medicine.

Blood or salivary testing is sometimes offered but there is no evidence that adrenal fatigue exists or can be tested for.[1][3] The concept of adrenal fatigue has given rise to an industry of dietary supplements marketed to treat this condition. These supplements are largely unregulated in the U.S., are ineffective, and in some cases may be dangerous.[3]
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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?

The main purpose of your adrenals is to enable your body to deal with stress from every possible source, ranging from injury and disease to work and relationship problems. Adrenal function is of paramount importance because these small glands play a pivotal role in determining the way your body responds to every change in your internal and external environment
Hi Dr. Jill – I have a theory that i would love to get your opinion on? I believe that i have adrenal fatigue and also urinary retention. I have puffy eyes, especially on the bottom. I have Hashimotos any many other issues. I am trying to figure out the cause of the urinary retention and have noticed that when i get hyped up, such as when rushing for an important occasion, such as a wedding , funeral or such that i have a great release of my bladder when i am rushing to get ready for the occasion. I am wondering if it is the adrenal fatigue that is causing the retention and then when i am rushing around and using up my reserve energy , that is when my bladder releases the urine. Any input would be much appreciated, thank you!

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 contents displayed within this public group(s), such as text, graphics, and other material ("Content") are intended for educational purposes only. The Content is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your healthcare provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in a public group(s).
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.
The easy, relaxed lifestyle experienced by our ancestors no longer exists, and we're not even aware of how much stress we're under. The problem? "Our lifestyles have changed, but our bodies haven't," Dr. James Wilson said in his November lecture at the First Arizona Choices Exposition in Tucson, Ariz. A large portion of our population is feeling tired and stressed out, and we want to know why.
Adrenal fatigue is not recognized by the Endocrine Society or any other endocrinology society, but adrenal insufficiency is. One glaring problem for the adrenal fatigue concept is that the reported symptoms don’t match those from adrenal insufficiency, although there is some overlap. The adrenal fatigue symptoms are “mostly nonspecific” including being tired or fatigued to the point of having trouble getting out of bed; experiencing poor sleep; feeling anxious, nervous, or rundown; craving salty and sweet snacks; and having “gut problems,” says Nieman. For the most part, these do not match symptoms of chronic adrenal insufficiency, which is characterized by weight loss, joint pain, anorexia, nausea, vomiting, diarrhea, dry skin, low blood pressure, and fatigue.
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Some people call the time when the "camel's back" finally breaks a "nervous breakdown." However, nerves really don't break down; adrenal glands do. A "nervous breakdown" is actually adrenal fatigue, or when the adrenal glands can't deal with the amount of stress they're given. Adrenal fatigue used to be rare, but is now all too common because of our lack of relaxation and other lifestyle factors, such as smoking, sleep deprivation, poor eating habits and excessive caffeine intake, as well as allergies.
Dr. Wilson created adrenalfatigue.org specifically to help you and the many others experiencing this very common problem caused by too much stress. Take the Adrenal Fatigue Questionnaire to see if low adrenal function may be your problem. Learn more about adrenal fatigue and how stress and adrenal function can affect your health and other related health conditions. Follow the guidelines for adrenal recovery Dr. Wilson developed over decades of clinical practice and research. Find a health professional familiar with adrenal fatigue to help you. Best of all, discover that you can reclaim your vitality and thrive in a stressful world!
The U.S. Food and Drug Administration (the government agency that oversees most food and medical products) does not oversee nutritional supplements and vitamins. This means there is no guarantee that what's on the label of a supplement is really what's inside the bottle. In some cases, supplements have very few, if any, active ingredients. In other cases, the dose of a particular ingredient may be too high. This is true if you purchase supplements from your local drug store or a specialty pharmacy (sometimes called a compounding pharmacy) where supplements are made directly by the pharmacist.
She begins with a central issue: the nature of stress. As she explains it, stress is not people, places, things, or events. Stress is not any external factor that somehow does things to you. Those are stressors. Stress, however, is nothing more than your mind and body’s reaction to those outside stimuli. Moreover, stress is not inherently bad for you either. Some stress reactions can save your life – such as the fight or flight response that provides your body with the burst of energy you might need to escape from momentary danger. Exercise is another example of a type of stress that can have positive impact on your life.
Part III tells you how to recover from adrenal fatigue. This part of the book leaves nothing out: it covers everything including lifestyle, diet, stress, supplements, and sleep. Wilson really wants you to examine your life for the real causes behind your health problems so you can make positive changes. He also believes that most cases of adrenal fatigue can be treated at home without the help of modern medicine, although he does provide suggestions for those with very severe adrenal fatigue who may need temporary natural hormone replacement so they function like a normal person and adopt better habits.
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.
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?
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The largest difference between them is that people with adrenal fatigue usually have cortisol levels that fall in “normal” levels but not “optimal,” while adrenal insufficiency patients have cortisol levels consistently outside the normal range. In addition, most conventional doctors would say that stress is not a causative factor in adrenal insufficiency (which is “always caused” by damage from other, unknown sources), which seems unlikely.


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.
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.
My life started to get better when I read this book. Every single improvement in my health over the past six months, and there have been many, have come from putting the advice in this book into action. I can not recommend it highly enough to people who want to do more, but just simply can not summon the energy and are tires of not knowing why they are so tired.
Well, any form of stress involves your nervous system. Specifically your sympathetic nervous system, a part of your autonomic nervous system. This system takes care of your blood pressure, digestion, breathing, heartbeat and sexual response. When these things need to increase because of a threat, your sympathetic nervous system is in charge and when they need to be relaxed, your parasympathetic nervous system cools them off.
I am lucky to have lived now for 12 years with a heart transplant, requiring that I take myriad drugs to suppress my immune system and manage inflammation, as is the normal course. With a suppressed immune system, one is vulnerable to infections and I have been no exception. Every winter I am sick sick sick with colds and bronchial infections verging on pneumonia. But not this year. My PCP wondered if my adrenals had become “lazy” from prednisone doing their work for them. This fall we tried a daily dose of 1,000 mg of B12. The boost of energy was immediately noticeable. Most importantly, I fought off a cold, unheard of for the past 12 years—even during a very stressful period over Christmas in which my husband was suddenly diagnosed with cancer (in remission already!). Despite all the stress of caring for him and being with him in the hospital, exposed to pathogens for weeks during flu season, I remain astonishingly vigorous and well. I would recommend that heart transplant patients and others with suppressed immune systems explore this solution with their clinicians. I am only a short-term case-study of one, but the difference has been astonishing—and right at the moment I needed the wellness to save my husband’s life.
Wondering if any of you have this happening…my symptoms are worse each month around the same day the 20th. Starts out feeling flu like massive headache, body aches slight fever, nausea. And in 2-3 days it starts to dissipate and then moves to my lower back and nerve like radiating pain in my lower back. Usually lasting 2-3 days, this month it came earlier and lasted longer 6 nights to be exact. Happens like this each month. Today, the Endocrinologist told me it’s not hormones/menopausal. What the heck!!
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.
CoQ10 plays a vital role in helping the body to manage stress. Research has shown that supplementation with CoQ10 helps to reduce signs of inflammation in the blood and fight oxidative stress. Stress is a significant cause of inflammation, which – on top of adrenal fatigue – is linked to chronic health problems of the brain and cardiovascular system. Your stress-coping mechanisms become weaker with age, and are particularly vulnerable when cortisol is running low.
Your adrenals produce your stress hormones, which are super important for your metabolism and they totally effect your thyroid so it’s key to look at these glands when you’re dealing with any sort of thyroid issue. If you’re in that amped-up mode that causes you to feel stressed all the time (and you feel like you can’t turn it off), you’re headed for some degree of Adrenal Fatigue. In this state, your cortisol is chronically elevated or it’s high when it should be low (at night). Adrenal Fatigue is when your cortisol is chronically low when it should actually be elevated. Your production of stress hormones declines and leaves you with low adrenaline and low cortisol–feeling depleted.
The lack of a biological explanation can be disappointing. To make things worse, it’s not unusual for doctors to say “there is nothing wrong with you” or “this is all in your head.” The overwhelming amount of information on the Internet that recommends many types of treatment causes even more stress. Mental health conditions, such as depression or anxiety, may have symptoms similar to adrenal fatigue and may not respond well to antidepressants and counseling. And some patients do not believe that a mental health concern is the primary cause of their symptoms and many refuse medications due to concerns about their side effects.
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