Adrenal fatigue (also called adrenal insufficiency) is a common health problem that is often overlooked or misdiagnosed. One of the biggest contributing factors in adrenal fatigue is stress-something we all tend to have in abundance in our lives. Interestingly, some people get so used to living with stress that they don't even realize how much of a toll it's taking on their bodies. Weight gain, diabetes, depression, and high blood pressure are just a few of the physical problems that can result from this potentially debilitating illness.



The adrenal glands are part of the endocrine system and are anatomically located on the superior aspect of the kidneys. The adrenals produce a variety of hormones that are responsible for handling stress. Cortisol is released for the purpose of coping with long-term stresses such as chronic allergies or infection, insomnia, poor diet, repeated stresses, overexertion, fear, lack of or excess of exercise, and helping the body process prescription or non-prescription drugs. Epinephrine and norepinenphrine are released in acute stress situations such as sudden job loss, the death of a loved one, surgery, divorce, or physical or mental trauma.

Your body usually recovers from a stressor within 1-3 days after proper rest. However, if the stressors in your life become chronic and levels of cortisol and epinephrine remain elevated, the elevation may result in weight gain, insulin resistance, diabetes, increased susceptibility to infections, autoimmune conditions, high blood pressure, osteoporosis, depression, and other degenerative diseases.

Chronic stress can eventually cause adrenal exhaustion, resulting in lowered cortisol production that can lead to lack of energy, decreased ability to handle stress, lowered libido, chronic fatigue syndrome, low motivation, fibromyalgia, anxiety disorders, and even death. A complete failure of the adrenal cortex is called Addison's disease.

Diagnostic Tests

There are specific lab tests that I use to diagnose adrenal insufficiency. I check salivary cortisol levels that tell us the amount of hormone inside cells. We collect saliva specimens four specific times during the day. It is a simple non-invasive procedure that can be collected in the privacy of your home. The patient can then mail in the take-home kit to the lab after collection. I also will test other steroid hormones such as DHEAs and testosterone that if low can be indicators of adrenal exhaustion. We'll also check your blood pressure in the office to monitor hypotension (low blood pressure) and light-headedness when standing. If I suspect insulin resistance, I will run a fasting insulin lab.

Treating Adrenal Fatigue

The treatment options vary depending on the clinical signs and symptoms the patient presents and the results of the individual lab results. There are combination herbal adrenal support formulas or single herbs. It is also important to integrate appropriate vitamin/mineral mixtures specifically to support adrenal/hormone production. There are also glandular extracts that are designed for adrenal support. In severe cases of adrenal fatigue steroid therapy is recommended. DHEA supplementation may help protect from overproduction of cortisol and enhance the immune system. Since the adrenals release sex hormones these must be supplemented according to lab results. All hormones given are compounded bioidentical hormones that act more like the body.

Proper nutrition is also an important factor in healing the adrenals: small, frequent meals with protein, whole grains and healthy oils should be part of the patient's diet.

Most important of all, the patient must begin to incorporate lifestyle changes. You should minimize stress, seek to balance work and relaxation, and consistently engage in moderate exercise. Other stress reducers would include daily meditation, minimizing contact with negative people and events, and sleeping eight hours per night with mid-afternoon naps, if possible.