Robin Berzin MD is a functional medicine physician and the founder of Parsley Health. Her mission is to make functional medicine affordable and modern, so that more people can access this holistic, root-cause approach to health. A Summa Cum Laude graduate of the University of Pennsylvania, Robin went to medical school at Columbia University and later trained in Internal Medicine at Mount Sinai Hospital. She is also a certified yoga instructor and a meditation teacher, and has formally studied Ayurveda. Robin writes for a number of leading wellness sites, and speaks regularly for organizations including the Clinton Foundation, Health 2.0, Summit, and the Functional Forum, on how we can reinvent health care. She's also an mindbodygreen courses instructor, teaching her Stress Solution program designed to help you tune down the stress in your life and tune up your energy and happiness.
Adrenal fatigue should not be confused with another medical condition called Addison’s disease where the adrenal glands are not functioning at all. While Addison’s disease is often caused by autoimmunity, Adrenal Fatigue is largely caused by stress along with a host of other factors, like accumulation of toxic exposures, hidden infections, hormone imbalance, or even nutritional deficiencies.
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.
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.
The adrenals are two small glands that sit on top of the kidneys and produce several hormones, among them, cortisol. When under stress, we produce and release short bursts of cortisol into the bloodstream. The adrenal fatigue theory suggests that prolonged exposure to stress could drain the adrenals leading to a low cortisol state. The adrenal depletion would cause brain fog, low energy, depressive mood, salt and sweet cravings, lightheadedness, and other vague symptoms.
When you live in the fight/flight mode all the time and you’re constantly stressed out, you’re setting yourself up for adrenal fatigue because they’ve been in overdrive for a long period of time and they’re been flooding your body with cortisol until they can’t keep up with the constant demand for more stress hormones. Now, your adrenals cannot produce enough stress hormones and/or they’re producing the wrong types of hormones at the incorrect times.
Methylation labs: Methylation is a massive biochemical superhighway that happens 1 billion times every second in the human body. It makes a healthy brain, gut, hormones, and detox pathways and protects your DNA. All super important stuff. Genes that make methylation happen can be mutated in some of us. This decreases methylation and can cause a variety of health issues. I had multiple methylation gene mutations, one of which is the MTHFR gene.
Hello, at Age 51, 5’6″, Nothing has changed, i am still 165 to 170 depending on the Decision of GOD knows what, i went down to 163 last June after climbing to 170 and was ecstatic, no change in diet, i cannot exercise due to the Fibromyalgia (long story) but i am the busiest person i know, i hardly EVER sit down. My period was 2 months late in June of 2015, then it started, and my weight dropped 7 pounds in 5 days ! (from 170 to 163 in June 2015) i did nothing diff, then it climbed back up , doing nothing different, only my period was late again, for another 2 months.
At LifeWorks Wellness Center, when the patient has been diagnosed with adrenal fatigue, the practitioner will describe the adrenal fatigue treatment options available. These may include identification of specific adrenal support needed for the patient, as well as the correction of other health factors which put additional demands on the adrenals. The causes, and severity, of adrenal fatigue vary from person to person. For this reason, all adrenal gland treatment programs are individualized based on what is needed.
I’ve just started taking Siberian Ginseng (in drop form) and just after the first dose, it had an immediate effect and I started to lose the water I had been retaining and I’m not feeling so “dead” in the mornings. I understand it’s best to take it for up to 3 weeks and then have a break from it. I’ll try 2 weeks and 2 weeks off maybe and see how that goes. I’m also using Natural Progesterone cream (morning and evening) – Emerita is the make – as well as other things but definitely noticed a huge different with the Ginseng. I shall continue.
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.”)
Like most books on the topic, Dr. Luther’s guide begins at the beginning: with a discussion of stress, the adrenal system, and the stressful nature of modern life. That leads to an examination of how the various systems of the body communicate with one another, and the way that stress impacts every aspect of health. From there, it moves on to an examination of the stress response, which is the source of all adrenal fatigue issues.
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.
And I still feel that way, except maybe I will do it tomorrow . . . after a long siesta. . . or later, like when the cows come home. Because frankly, my “Need To Do” list (go to the grocery store) and my “Want To Do” list ( take a NAP) have not been getting along lately. Yes, I love life and want to do ALL THE THINGS, but maybe I shouldn’t try to do them all at once, you know?

Toxic metals and chemicals often play a large role in adrenal burnout. Everyone is exposed to thousands of chemicals in the air, the water and the food. Other sources are dental materials and skin contact with chemicals. Over-the-counter and prescribed medications add to the body’s toxic load. Most people do not realize that antibiotics and many other drugs accumulate to some extent in the liver and other organs. Toxins may also be generated within the body due to impaired digestion. When food is not properly digested, it either ferments or rots in the intestines, producing many harmful substances that are absorbed into the body. A healthy body has the ability to eliminate many toxins on a daily basis. However, as adrenal weakness develops, the body’s ability to eliminate all toxins decreases. This produces a vicious cycle in which weaker adrenals impairs the elimination of all poisons, which then further weakens the adrenals.

Do you find that the slightest amount of stress leaves you feeling overwhelmed? Adrenal Fatigue sufferers often have a difficult time dealing with physical or emotional stress. This is for exactly the same reasons that are behind that unrelenting feeling of tiredness. It all comes back to the low hormone levels associated with late-stage adrenal exhaustion.
Those Adrenal Fatigue sufferers who are at a later stage of the condition will have consistently lower levels of cortisol. However, their blood sugar will tend to be much lower during the early morning (cortisol regulates blood sugar too). Your body realizes it’s hungry and forces you to wake up. Many Adrenal Fatigue sufferers are chronic late-night snackers for exactly this reason. You can get a better night’s sleep by improving your sleep hygiene.
Any excessive stress can deplete the adrenals. Excessive workload, long hours, lack of sleep, or emotional stress are common.  Other stressors in cities are noise and electromagnetic pollution. Cell phones, microwave towers and appliances like televisions, cell phones, wearable electronics,  microwave ovens and computers give off strong EMF fields that can be stressful to our bodies
Prior to having my left Adrenal Gland surgically removed last month after the recommendation of an endocrinologists, I struggled from moderate adrenal fatigue, high blood pressure, low potassium, etc. The removal of the gland was to eliminate the need for blood pressure medicines all together. It didn’t seem to work. I have sever adrenal fatigue, sever high blood pressure, continued weight gain of my mid section, and now depression. Any advice?
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.
Low energy and tiredness are among the most common reasons patients seek help from a doctor. Despite being so common, it is often challenging to come up with a diagnosis, as many medical problems can cause fatigue. Doctors engage in detective work, obtaining a medical history, doing a physical exam, and doing blood tests. The results often yield no explanations. It can be frustrating for clinicians and patients when a clear-cut diagnosis remains elusive. An attractive theory, called adrenal fatigue, links stress exposure to adrenal exhaustion as a possible cause of this lack of energy.

The basic 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.


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.
Like most books on the topic, Dr. Luther’s guide begins at the beginning: with a discussion of stress, the adrenal system, and the stressful nature of modern life. That leads to an examination of how the various systems of the body communicate with one another, and the way that stress impacts every aspect of health. From there, it moves on to an examination of the stress response, which is the source of all adrenal fatigue issues.
Everyone comes from different backgrounds and have various experiences that affect their outlook on life; therefore, their view of something might be totally different than someone elses perspective. I like how you responded Heather, because after all we are real people even though we don’t talk face to face we still need to try and understand each other. This is part of life learning from one another.
That discussion leads to a more in-depth explanation of how our understanding of the nature of stress has evolved in recent years, and then an explanation of how the adrenals work to provide the hormones we need for stress response. From there, she quickly moves to a discussion of the circadian rhythm, and how its dysregulation can impact sleep patterns and ultimately lead to a cascading series of system failures that put your health in jeopardy.
I have Hashimoto’s and adrenal fatigue. I don’t know what’s causing my adrenal fatigue or how to find that out. Is it the autoimmune attack? Gut infections? Food sensitivities? The fact that I’ve been to like 50 doctors and nobody can help and they make me so stressed I want to yell at them? I also go to bed really late like 4am. And my blood sugar is chronically low despite eating protein and fat with each meal so I have these awful blood sugar swings which I’m sure is hard on the adrenals. I just don’t know how to figure out the cause and reverse it. Can you reverse it without figuring out the cause by taking a B complex and Vitamin C?
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.
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.
Adrenal fatigue is a condition that usually results from a long period of chronic stress. Over time, this stress taxes the adrenal glands and HPA axis, thereby disrupting the production of cortisol and other hormones. The body initially produces large amounts of cortisol to cope with the stressors, but eventually cortisol levels drop. The cortisol cycle can also become dysregulated, with irregular peaks in the evening.
The Metabolism Plan: Discover the Foods and Exercises that Work for Your Body to Reduce Inflammation and Drop Pounds Fast is not written specifically for people with adrenal fatigue, however, in this 2017 updated version of her original book The Plan, the author devotes chapters to thyroid function as well as the adrenal/cortisol connection to your body's metabolism, and explains how eating foods that you are reactive to can depress thyroid and adrenal function, as well as prevent you from losing weight. She teaches you not only how to monitor your body for signs of food sensitivities (as in the first book), but also how to assess different styles of exercise, to see if your workouts could be the reason you are not losing weight! This book in my opinion replaces the original verson (you probably don't need to read both, the actual diet is the same) and is at the top of my must-read list for planning your adrenal fatigue recovery!
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.
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.
i have been dealing with fatigue and major hair loss for the last 4 years. It use to go in cycles of 4 months then would get better but this last year has not cycled this has been going on for a year now. I wake up and two hours later need to sleep for 2-4 hours and am drained again around 5-6. No doctors have seemed to be able to figure it out. any help would be a blessing.
Do you feel that your energy levels are just at a permanently lower level than they used to be? Aging is often a factor in this, but chronic stress can be a major contributor to exhaustion too. If you’re one of those people who find themselves drinking more and more coffee just to get through the day, it might be time to look at the underlying cause behind your tiredness.
This not at all how Addison’s is dianosed. Addison’s testing usually entails an 8 am cortisol draw at a lab. They will also usually conduct an ACTH stim test to confirm. I hope you made it to an endo. They will not diagnose you with adrenal fatigue as there is no such diagnosis, and thus, no such diagnosis code. Your insurance company will not recognise adrenal fatigue either.
Ideally, cortisol is released into the system only on an occasional basis, rather than in response to chronic stress. If cortisol levels become too high for too long, they may have undesirable side effects, including loss of bone density, muscle wasting, thinning of the skin, decreased ability to build protein, kidney damage, fluid retention, spiking blood sugar levels, weight gain, and increased vulnerability to bacteria, viruses, fungi, yeasts, allergies, parasites, and even cancer.
Spending more time outside in the sun also helps boost levels of vitamin D, because your body manufactures this important vitamin/hormone when it senses sun on your skin. Vitamin D, is responsible for regulating over 200 genetic pathways, so make sure your levels are high enough. I recommend an optimal range of around 60 to 80 ng/ml. Ask your doctor about a simple blood test to help you keep track.

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.

You may also be told to buy special supplements or vitamins. These supplements claim to be made just for adrenal health. While regular vitamins and minerals may be good for your health, doctors are concerned that supplements or vitamins sold as a treatment for adrenal fatigue could hurt you. Many of these supplements have not been tested for safety.
Secondly, this is an EARLY indicator of adrenal fatigue. Pupillary contraction is not nearly as high on the priority list for your adrenals as, say, blood sugar control or blood pressure maintenance. So not doing well on his test doesn’t mean you’re in dire straights and need major intervention. Having reactive hypoglycemia or scoring poorly on a postural hypotension test (blood pressure dropping when you stand up, getting dizzy/tunnel vision when you stand) are better indicators of real hypoadrenia.”

After determining that adrenal fatigue is a widely misdiagnosed syndrome, Dr. Zodkoy goes on to discuss the nature of adrenal fatigue, its symptoms, and the most effective exams and lab tests for detecting problems with the adrenals. He also gives insight into his own thought process regarding why so many adrenal fatigue patients fail to produce lab results confirming their condition.


At some point in all of our lives we go through a period of feeling tired, run down or exhausted without being able to point to a readily identifiable reason. Whilst such symptoms could be attributed to a variety of factors – some lifestyle related and some related to identifiable medical conditions – some people take the view that a condition known as adrenal fatigue could be an underlying cause, and that this is an issue of increasing importance. Your adrenal glands are fundamental to a healthy body and mind – they produce a variety of key hormones, including those underpinning our “fight or flight” responses. Looking after the adrenal glands, and the wider endocrine support system is, therefore fundamental. This book explains why your adrenal glands and the hormones they produce are so important. The book then gives some analysis of why diet, exercise and stress levels are important in relation to the functioning of the adrenal glands – and what you might be able to do to develop a more robust system – also likely improving your overall general health in the process. The goal of this book is to give you the tools to help you understand the condition, consider whether or not you need to seek medical attention, and set yourself on a path to self-treatment and complete recovery. Even in broader terms, if you have ever felt that you may be somewhat low on energy, then we urge you to read this book, and put its advice into practical, daily use.

I have been working in a very high stress environment for the last several months. Within a month of starting this job I started having what felt like heart attacks but which the ER docs told me were panic attacks. I ended up having to take a leave of absence to recover and finally resigned when I realized that I literally dreaded going back to work to that point that every time I thought about returning I felt the anxiety attacks starting. It’s been a month now since I quit and I still feel physically exhausted and unhealthy with frequent heart palpitations and dizzy spells. Drs including cardio can’t find anything physically wrong with me. Does this sound like adrenal fatigue to you? If so, How do I get my health back to normal? FYI I’ve been in perimenopause for about 3 years now I still get my period about once every 3-4 months and they are generally very heavy and last for about 3-5 days.
Medicinal Mushrooms: Because of the way mushrooms such as cordyceps and chaga interact with the body and various medications, it is recommended that pregnant or nursing mothers never use them. In addition, anyone with autoimmune conditions, diabetes or a bleeding disorder should not use medicinal chaga or cordyceps. These is one case report of chaga supplementation causing kidney damage in a woman with liver disease who took chaga every day for six months. This mushroom also contains oxalates and may inhibit some nutrient absorption in large doses. (45)
Hi Ladies…I too have all the symptoms above and can relate to you all…I am only 39 and this is my third year…I too feel like this is never going to end.I eat very clean…no dairy wheat gluten or meat…I exercise yoga twice to three times a week and walk….I have tried every holistic avenue… But am still trying and will not give up…I do believe the way we live today is a massive cause…Being busy has become the new NORM….I wish us all love and luck…love sonia xzz

I have Hashimoto's and third stage adrenal fatigue. I've had Hashi's for 15 years. With Dr. Lam, I finally figured out that my issue is "adrenal fatigue syndrome," NOT just adrenal fatigue. I am actually taking Dr. Wilson's adrenal quartet, which has helped me immensely. (I also have Dr. Wilson's book.) Dr. Lam offers a similar adrenal fatigue regimen, but right now I'm not sure if I should try to switch from Dr. Wilson's adrenal supplements to Dr. Lam's - I may do so in the future.

A Practical Guide To Addison's & Adrenal Fatigue: Advice For Dealing With Addison's/Adrenal Fatigue From A Female Over-Achiever Diagnosed At 31 is the work of Regan J. Heineken, an adrenal fatigue sufferer whose chronicling of her own healing journey became a treatment guide that she decided to share with the world. At fewer than 70 pages, it’s another easily-accessible work on the subject of the adrenals and varying levels of fatigue.


Stimulant use, however, can also be a result of adrenal burnout. While stimulants can cause or contribute to adrenal weakness, some who use stimulants do so because they are in adrenal burnout already. Stimulants are attractive to one in burnout to provide temporary energy. This is an important appeal of the drug culture, both legal and recreational. It is also the appeal of loud music, sexual addiction, and even anger.
Nutrition is key and combined with my step-by-step guides you will gain from my experience and background as a mainstream practitioner in helping you flourish with these new alternative approaches. A natural balanced internal state within the body is the foundation to returning it to optimal health. There is tremendous power and ability in supporting the body to do what it naturally does very well, to heal and regenerate. I do hope you find these step by step guides informative, effective and helpful so that you may improve your overall wellbeing and can live the life you have always dreamed of.

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.

What's to know about pheochromocytoma? Pheochromocytoma is a rare, potentially life-threatening tumor of the gland in the body that produces adrenalin. In this article, learn about the symptoms of pheochromocytoma and their potential complications, as well as the function and anatomy of the adrenal gland. Read on to find out about outlook with the tumor. Read now
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