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.
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.

Treating Adrenal Fatigue requires lifestyle changes, for example an improved diet and exercise routine, along with appropriate supplementation and even some emotional counseling. Even if your MD is willing to go through these steps with you, the limitations of our overcrowded healthcare system make it impossible for him or her to do so. Modern healthcare aims to get patients in and out of the clinic as quickly as possible, and it encourages the use of prescription medicines to treat symptoms, rather than attempting to diagnose and treat the underlying problem.
While CFS and adrenal fatigue are not the same, adrenal function may play a role in it. Those with CFS are often found to produce a low amount of the hormone cortisol, which is produced by the adrenal glands. Furthermore, CFS is a malfunction of the pituitary, a pea-sized gland at the base of the skull, which regulates all our hormones. The pituitary, hypothalamus and adrenals all work together as part of the HPA axis to regulate our health and hormones. Analysis of the data in over 50 studies that assessed adrenal function in CFS and fibromyalgia patients demonstrates that the majority of these patients have abnormal adrenal function due to hypothalamic-pituitary dysfunction.
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 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! )
Adrenal Fatigue Syndrome comes from a failure of the adrenal glands to efficiently produce hormones. The adrenal glands secrete cortisol, a hormone fundamental to optimal health. An excess of cortisol in the body can lead to severe problems, including Cushing’s syndrome. However, when released in normal levels by the adrenal gland, cortisol is essential to helping our bodies cope with stress and to fight infection – without cortisol the body cannot sustain life! Balance is crucial. Cortisol affects every tissue, organ, and gland in the body. When the adrenal glands are fatigued, they do not supply the body with enough cortisol. The body does what it can to get by, but it is not without consequences. As such, Adrenal Fatigue Syndrome generally precedes other chronic conditions.
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
This one is still hard for me – I don’t want to disappoint anybody and there is always more work to be done. But managing stress means creating space in your life to refuel, spend time with the people you love, and doing what you need to do for you and you alone. Don’t just pencil it in. It’s as important as anything else you do for your health, and maybe more so.

Deficiencies in hormones like cortisol, DHEA, aldosterone, pregnenolone, estradiol, progesterone, testosterone and growth hormone are often missed or poorly treated because doctors have come to rely on standard blood tests that require an intact pituitary and hypothalamus for diagnosis and dosing of hormone levels. There is, however, severe hypothalamic and pituitary dysfunction with CFS, making the standard blood tests inadequate. Evaluating hormone function, not just hormone levels, can help diagnose CFS and adrenal fatigue; and when properly treated and balanced, tremendous results can be achieved.
Many people today have subclinical deficiencies of essential nutrients, like B vitamins, Vitamins A, C and E, Magnesium, Zinc,  and other trace elements.  When under stress, the need for nutrients is even greater. Refined carbohydrates stress the adrenals as well. Diets low in protein may also create deficiencies.   The Standard American Diet is both high in processed carbs and sugar and lower in quality fats and protein and many times lacking in micronutrients.
To our knowledge, this is the first systematic review made by endocrinologists to examine a possible correlation between the HPA axis and a purported “adrenal fatigue” and other conditions associated with fatigue, exhaustion or burnout. So far, there is no proof or demonstration of the existence of “AF”. While a significant number of the reported studies showed differences between the healthy and fatigued groups, important methodological issues and confounding factors were apparent. Two concluding remarks emerge from this systematic review: (1) the results of previous studies were contradictory using all the methods for assessing fatigue and the HPA axis, and (2) the most appropriate methods to assess the HPA axis were not used to evaluate fatigue. Therefore, “AF” requires further investigation by those who claim for its existence.
Unlike other endocrine disorders that are caused by physical damage to parts of the adrenal glands, hypoadrenia is seen by many in the natural health world as a “middle ground” syndrome with simple and easy-to-implement solutions. Currently, no official diagnosis exists for adrenal fatigue and people are either considered to have normal endocrine function or total endocrine failure, like that seen in Cushing’s syndrome or adrenal insufficiency/Addison’s disease. Some postulate that this occurred in the 1950s when doctors over-prescribed adrenal steroids and saw dire consequences, leading to an overcorrection and generalization of endocrine issues. (2)
Carbohydrates: While carbohydrates aren’t all bad for you, the inflammation they can cause is particularly problematic when experiencing adrenal fatigue. Many people crave carb-heavy foods when they’re stressed, which offer a momentary satisfaction but end up taxing the adrenal glands more. If you’re overwhelmed and stressed out, try kicking the gluten and starchy carbs for a period of time to see if that may regulate your tiredness and energy levels.
Thank you for your article! I just received saliva test results showing that I have low cortisol throughout the day. I’m on a supplement plan, but I’m wondering about some of your other recommendations. What is the benefit of going to bed at 10 PM For the adrenals? If I am awake between 7 AM and 9 AM, what do you recommend for being restful for the adrenals? Thank you!!
Deficiencies in hormones like cortisol, DHEA, aldosterone, pregnenolone, estradiol, progesterone, testosterone and growth hormone are often missed or poorly treated because doctors have come to rely on standard blood tests that require an intact pituitary and hypothalamus for diagnosis and dosing of hormone levels. There is, however, severe hypothalamic and pituitary dysfunction with CFS, making the standard blood tests inadequate. Evaluating hormone function, not just hormone levels, can help diagnose CFS and adrenal fatigue; and when properly treated and balanced, tremendous results can be achieved.
Until the adrenal fatigue controversy is teased out, focus on engaging in healthy habits like seeing your doctor for regular checkups, getting enough sleep, avoiding or moderating caffeine intake, and eating a nutritious diet. Some people opt for a low-glycemic diet (for its anti-inflammatory effect), but talk with your doctor first before embarking on this.
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.

The adrenal glands secrete over 50 hormones including the metabolic intermediates (known since 1965). The adrenal glands are important glands to keep us balanced. Norepinephrine fight or flight hormones are needed the first part of stress response. Most of adrenal glands regulated by blood flow – HPA Axis and hormones. Most of our hormones are secreted by adrenal glands so if are adrenals are tired and overworked then the hormones may become below normal levels. The sex hormones and the stress hormones need to work together. Blood sugar is important to keep normal during stressful situations. If adrenals are not functioning their best, then we can’t perform as well as we need to. If cortisol is too low or too high, then other hormones may be out of balance- the body is very delicate and has innate intelligence to keep functioning with daily demands of life.


This is a very informative book with information on everything from symptoms to how to find relief and better health. Unlike other "health" books I've read, this one gives very complete information. An example is that many books will suggest you add or take away certain types of foods from your diet. This one gives lists of not just a category of foods - but the actual food items themselves AND tell you the best ways to prepare them.

Less obvious but no less important stimulants may include anger, rage, arguing, hatred, loud music, fearful news and even movies full of suspense or violence. Other activities that may act as stimulants and must not be overlooked include vigorous exercise, sexual preoccupations, recreational drug use or other thrills. These often provide a temporary “high”, which is caused in part by the secretion of high amounts of adrenal hormones. However, over time, this weakens the adrenals and can eventually lead to adrenal depletion and insufficiency.
There’s no science to back it up. The Endocrine Society, the world's largest organization of endocrinologists (people who research and treat patients with diseases related to glands and hormones), flatly says that adrenal fatigue is not a real disease. And it says the symptoms of adrenal fatigue are so general, they can apply to many diseases or conditions (depression, sleep apnea, fibromyalgia) or stem from everyday life.
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