Adrenal Fatigue and Exhaustion
Adrenal fatigue and adrenal exhaustion are practically an epidemic in our society today and are responsible for a vast number of debilitating symptoms, and yet most people are unaware that they have the condition. Adrenal fatigue, also referred to as hypoadrenia, develops when the adrenal glands no longer produce their hormones properly and do not function optimally.
The adrenal glands are two small glands about the size of a walnut sitting on top of your kidneys that play a very large role in your level of emotional and physical health. They are responsible for the production of a variety of hormones that are critical to many body functions and systems like maintaining blood sugar; managing stress and fatigue; converting carbs into energy; gluconeogenesis (turning protein and fat into glucose); regulating the immune system and inflammatory response; normalizing blood pressure; electrolyte balance; the distribution of stored fat; cardiovascular function; and regulating our fight or flight response system. Malfunctioning adrenal glands lead to excessive fatigue, exhaustion, cravings for sweets and caffeine, inability to handle stress, unstable blood sugar and a variety of other debilitating symptoms.
The outer portion of the gland is called the adrenal cortex and this is where cortisol, aldosterone, DHEA and a small number of sex hormones are produced. The inner portion of the gland is called the medulla and it produces norepinephrine and epinephrine, also known as adrenaline and noradrenaline.
The most crucial stress hormone produced by the adrenals is cortisol because it counteracts stress. It supports our need to cope with stress. When the adrenals are fatigued, they no longer produce enough cortisol, or they may produce too much at inappropriate times in the earlier stages of the condition. When there isn't sufficient cortisol in the body, then the individual is susceptible to auto-immune disorders, chronic pain syndromes, chronic fatigue, asthma, allergies, and more. In an attempt to self-medicate the many symptoms that occur as a result of malfunctioning adrenal glands, the individual often reaches for drugs and alcohol, or caffeine and sugar which only perpetuates the problem even further.
DHEA is important because it defends the body against breakdown from chronic stress and is the precursor to estrogen and testosterone. It works in conjunction with cortisol to support stress; one assists by providing energy and generating some breakdown, while the other opposes.
However, another important adrenal hormone that you don't hear too much about is aldosterone. It regulates the balance of sodium and potassium in the body, which in turn helps in controlling blood pressure, electrolytes and the distribution of fluids. It too can become depleted and contribute to adrenal fatigue. Low levels of aldosterone often accompany low levels of cortisol, but not always.
The longer one goes without adrenals that function adequately the more symptoms that develop. Over time other organ systems begin to malfunction as well as they try to compensate for the weary adrenal glands.
Adrenal fatigue usually occurs in phases and the further you progress through the phases the more symptomatic you will be and the more serious the issue becomes. In the early phases of adrenal fatigue, you may respond quite well to a variety of natural treatments, but as it progresses the substances that would normally help in this situation actually perpetuate the problem.
When adrenal fatigue progresses to the last phase, it is called adrenal exhaustion. At this point, the adrenals are hardly functioning at all and the individual may have a hard time staying ambulatory throughout the day and dealing with any stress seems like a monumental task. Their overall health at this point is severely compromised. This is a dangerous stage and requires the guidance of a skilled physician with expertise in advanced adrenal exhaustion. If not attended to adequately, advanced adrenal exhaustion can result in death.
How Does Adrenal Fatigue Develop? - Causes of Adrenal Fatigue
Stress hormones are needed when we are facing a dangerous, threatening, or emergency situation; they provide us with extra strength, energy, and alertness to deal effectively with the situation at hand. However, overstimulation of the adrenal glands is what leads to adrenal fatigue.
The primary system involved in the bodies stress response system is known as the HPA axis, which involves a complex interaction between the hypothalamus, pituitary, and adrenal glands. It is responsible for controlling essentially all the body's hormones, nervous system activity, storage and expenditure of energy, as well as regulating the immune system, controlling reactions to stress and a variety of other body processes like digestion, mood, emotions, and sexuality.
When you're under stress, the hypothalamus releases a hormone called corticotrophin-releasing factor, or CRF, which then flows through your pituitary gland and stimulates the release of adrenocorticotropic hormone, or ACTH, which then stimulates the adrenal glands to release cortisol. This process makes you alert and gives you the energy needed to deal with the stressful event.
In a normal circumstance, once the threat (the stressful event) passes then the hormones recede and the body returns to its non-stress state. However, in the fast-paced, high-stress life that most people live in these days and the diet they eat this cycle is ongoing. Overstimulation of the adrenal glands keeps the system releasing stress hormones on a regular basis. The body is in a constant state of fight or flight and eventually burns itself out. When cortisol is released too much and too frequently, then eventually the adrenals stop putting out cortisol out at the levels that are required for optimal functioning - adrenal fatigue occurs.
Overstimulation could occur from a one-time event where there is intense stress such the loss of a loved one or a medical crisis, or it can be the result of chronic, ongoing stress in your daily life that eventually builds up and grates away at the adrenals slowly.
Overstimulation of the Adrenals is Caused by the Following Primary Factors:
- Excessive stress
Too much stress in our life is #1 on the list of causes of adrenal fatigue. This can be from the demands of your job, raising a family, financial struggles, health conditions, too many responsibilities, relationship difficulties, etc. Anything in your life that causes you ongoing stress can lead to adrenal fatigue.
If you grew up with child abuse or neglect in your childhood, then you are likely to develop adrenal fatigue very young. A child living with any form of child abuse or neglect is in a constant state of fight or flight. Their adrenal glands never get a break as their body is continually releasing high levels of stress hormones like cortisol.
In fearful circumstances like abuse, stress floods the brain with cortisol repetitively and excessively. Over time this repetition damages the brain and the adrenal glands. In an attempt to adapt to this situation, the brain then lowers the threshold at which cortisol is produced to a dramatically lower level, however, the system remains in a hypersensitive state.
When a child is exposed to continuous and overwhelming stress early in life, such as abuse, it alters the production and release of their stress-regulating hormones like cortisol and essential neurotransmitters like epinephrine, dopamine, serotonin, endorphins, and GABA.
The scenario I just described above is also true of other high stress events like living with domestic violence, narcissistic abuse, surviving a natural disaster, prisoners of war, civilians living in a war zone, living with a chronic health condition, poverty, or any other event that threatens your livelihood and puts you in a constant state of hypervigilance.
Additionally, it is vital to understand that emotional stress is not the only type of stress that exists. There are many different kinds of chronic stress, that may include metabolic, oxidative, environmental, neuroendocrine, infectious, cognitive, structural, energetic, immune, and sensory.
- Sugar and carbs
The human body was not genetically designed to consume sugar and we need very little carb. A diet lacking in nutrients and/or high in carb puts a continuous strain on the adrenal glands as well as the liver, pancreas, and other organ systems and is the second leading contributor in the causes of adrenal fatigue.
When we eat sugar or carbs, they are absorbed very quickly by the body and bring our blood glucose levels up too quickly to an excessively high level. This sends an emergency signal to the pancreas to bring the blood sugar levels back down, so it releases an excessive amount of insulin to deal with the excessively high levels of blood glucose. Every time blood sugar goes up high or comes down too low, this is a stressor on the adrenal glands.
This, in turn, causes the body to call on the adrenal glands to release cortisol to bring the blood sugar levels back up because it works in conjunction with insulin to keep blood sugar in balance. Every time you eat sugar and carbs the pancreas and the adrenals go through this cycle and this puts too much demand on them and sets off the stress response system.
In time, as the adrenal glands are called on over and over to regulate this vicious pattern, the adrenal glands become depleted and they no longer release the amount of cortisol that is necessary for adequate functioning and then blood sugar stays in a consistently lower state and this leads to the problem of hypoglycemia in addition to adrenal fatigue.
Caffeine elevates our stress hormones. It triggers the body to release norepinephrine and epinephrine, the hormones involved in our stress response system, also known as the fight or flight response. As we discussed above, stress hormones are needed when we are facing a dangerous, threatening or emergency situation, they provide us with extra strength, energy, and alertness to deal effectively with the situation at hand. However, in the case of caffeine, there is no emergency to deal with and your body is put into the stressful fight or flight response on an ongoing basis for no reason at all. Your body is in a chronic state of stress.
An hour or so after you ingest caffeine the stress hormones dissipate and then you feel tired, hungry. and cranky so you reach out for more caffeine. This cycle puts excessive wear and tear on the adrenal glands and over time leads to adrenal fatigue.
Nicotine causes the liver to release high levels of sugar, which as we learned above, when high levels of sugar are in the blood the pancreas is alerted to release insulin to bring the sugar levels down. This results in a plunging of the blood sugar level and the excessive release of insulin and cortisol. Every time you light up you're causing this vicious cycle to ensue and will eventually burn out the adrenals.
- Environmental toxins
Common everyday chemicals found in your personal care products, cleaning supplies, perfume, air fresheners, cologne, dish soap, cosmetics, housing construction, laundry soap, pesticides, herbicides, etc. contain endocrine disruptors and are also a leading cause of adrenal fatigue.
The adrenal glands are one of the main glands involved in the endocrine system. Hormone/endocrine disruptors enter the body through our food, air, and water and attach to our hormone receptor sites and impede the normal functioning of the endocrine system, which results in a variety of abnormal reactions throughout the body. Keeping the endocrine system in balance is a very delicate process and it takes very little amounts of toxins to cause damage.
In some cases, endocrine disruptors mimic our hormones, which causes an excess, while in other cases it blocks hormones from being produced or functioning as they should.
The body is not capable of breaking down these kinds of toxic chemicals. Once they are taken in by the body, they are extremely difficult, and sometimes impossible to eliminate. They accumulate in our tissues and fat cells and continually recirculate throughout the body.
Heavy metals, particularly mercury, can directly inhibit output of adrenal hormones.
When the adrenal glands don't function properly, you can't cope or manage your stress adequately. This results in a vicious cycle where the fatigued adrenal glands cause even more stress and the elevated levels of stress continuously drain the adrenal glands even more.
- Candida overgrowth
Candida is a catch 22. On one hand, it is believed that weak adrenals will allow Candida yeast to proliferate in the body. However, on the other hand, the toxins that Candida emits alter and disrupt neurotransmitters and hormones in the body, thus disrupt the endocrine system, challenge the immune system, and put the body in a constant state of stress which weakens the adrenal glands.
Other common causes of overstimulation that leads to adrenal fatigue may include chronic illness, chronic infection, excessive exercise, gluten intolerance, malabsorption or maldigestion, surgery, sleep deprivation, parasite or bacterial infection, hypoglycemia, and alcohol and drug addiction. However on the flip side, sometimes people with adrenal fatigue become an alcoholic or an addict in an attempt to soothe their symptoms from under working adrenals.
The hypothalamus triggers the pituitary to release ACTH, which is what tells the adrenal glands to release cortisol. Therefore a problem in either one of these areas can contribute to how well the adrenals function as well. Antibodies to the pituitary, viruses, bacteria, trauma to the head, or tumors can all result in a low-functioning pituitary. Additionally, it is possible to be born with an under-active pituitary.
When the problem lies in the hypothalamus or an inability of the pituitary to produce ACTH, this is considered to be secondary adrenal fatigue. The problem is not in the adrenal glands themselves but in the lack of messages from the hypothalamus or the pituitary. An ACTH stimulation test can be used to determine if the condition is primary or secondary.
One may be also be born with a genetic impairment in their ability to produce aldosterone or cortisol, which results in weak adrenal glands.
Adrenal Fatigue Symptoms
It's very important to keep in mind that the symptoms of adrenal fatigue are shared with a variety of other conditions like thyroid disorders, hypoglycemia, neurotransmitter imbalances, hormonal imbalances, and many others. One should always seek the advice of a qualified healthcare practitioner who is highly skilled and knowledgeable about adrenal disorders and have testing to rule out any other possible conditions before assuming adrenal fatigue.
Hypothyroidism almost always occurs in conjunction with weak adrenals at least to some degree and many people are often diagnosed with a thyroid problem and the adrenal issue is ignored. The thyroid will be downregulated when the adrenal glands are not functioning properly because the adrenals can't deal with the stress that is associated with normal body functions and energy production, thus the cause of intense fatigue and lack of energy when one has weak adrenals. When there is low thyroid output, the adrenal glands need to be addressed first; the thyroid may take care of itself once the adrenals are functioning again. Treating the thyroid without treating the adrenal glands can cause more deterioration in the adrenal glands and the thyroid. Please read the following page for a more in-depth discussion of this particular aspect.People in the advanced stage of adrenal exhaustion can't stand up for very long, because they feel too weak. They must be sitting or lying down the majority of the day. Standing is essentially impossible.
- The primary symptom of adrenal fatigue is relentless fatigue and lack of energy that is not relieved by any amount of sleep or rest
- You feel weak, exhausted, and tired for no apparent reason on a regular basis
- You have difficulty getting out of bed in the morning, even when you had a reasonable amount of sleep
- You are slow to bounce back from an illness or stressful situations
- Cravings for salty food or sweets
- Inability to lose weight or weight gain, particularly in the waist area
- Lightheadedness when you rise from sitting position
- The need for stimulants to function in the morning or keep going through the day
- Trembling when stressed out
- Increase in PMS symptoms and/or menstrual flow that is heavy and stops and starts over
- Feel slightly better for a brief period after eating
- Frequent occurrence of flu or respiratory conditions
- Feel too tired to enjoy life
- You have more energy and feel more alert in the evening (however, this is true only in the early stages of adrenal fatigue. If you have advanced to the more severe stage of adrenal exhaustion, you don't have energy at any point of the day, including the evening.)
- Inability to handle stress is another classic hallmark in the list of adrenal fatigue symptoms
- Feel overwhelmed by little things
- Back or neck pain with no apparent reason
- Food sensitivities
- Low body temperature
- Feel better when not dealing with stress
- Low sex drive
- Difficulty in achieving daily tasks
- Dry skin
- Constipation and/or diarrhea
- Heart palpitations
- Mild depression
- Hair Loss
- Low blood sugar
- Loss of stamina and muscle strength
Conditions Associated with Adrenal Fatigue
Weak and malfunctioning adrenal glands are believed to be a major contributor in practically most medical and psychiatric disorders, however, the following conditions are some of the most common:
- Nervous breakdown (The adrenals lose their ability to deal with the stressful situation at hand.)
- MCS - multiple chemical sensitivity
- CFS - chronic fatigue syndrome
- FMS - Fibromyalgia
- Rheumatoid arthritis
- Anxiety disorders
- Hormonal imbalances
- Neurotransmitter imbalancnes
- PMS - premenstrual syndrome
- Autoimmune disorders
- Frequent infections
- Thyroid disorders
- Candida overgrowth
- Insomnia and Sleep Disruption
- Mild Depression
Additionally, it's also important to note that not everyone with adrenal fatigue will experience all symptoms that are possible. One person may have only a few symptoms, while another person may be completely incapacitated with symptoms. It depends on the degree of damage that is done to a particular person's adrenals and many other factors such as age, other conditions that may be present, the integrity of other organ systems in each person, which phase of fatigue they have progressed to, etc.
Adrenal Fatigue Diet
The adrenal fatigue diet should be free of sugar, caffeine, refined carbohydrates, alcohol, hydrogenated fats, soda pop, artificial sweeteners, and other junk food. It should be low in carbs, even complex carbs.
All food should be organic, free of hormones and include three meals or five smaller meals per day, no more than five hours apart.
A diet for adrenal fatigue should be high in animal protein like chicken, turkey, beef and buffalo or other meats like pheasant, duck and ostrich and moderate in fat. Eggs are good too. Fruit, nuts, and seeds should be minimal.
An adrenal fatigue diet should include lots of water, that is preferably filtered and free of chlorine and other contaminants.
Some people find a 1/8 to 1/4 tsp of salt (real, rock or Himalayan) added to an eight-ounce glass of water to be helpful, unless you have high blood pressure. This helps those who have a low level of aldosterone. If you have an exacerbation of symptoms when trying this technique, then you should discontinue.
Avoid eating fruit on an empty stomach. Eat them with animal protein and fat. Try sticking to fruits that are lower in sugar like raspberries, blueberries, blackberries, blueberries, strawberries, apples, pears, plums, and kiwis.
Salt should be used liberally as preferred to taste pleasant, but use rock salt or Himalayan salt, not table salt. Real salt is slightly pink or gray in color.
It should be limited in complex carbohydrates because even complex carbohydrates break down into sugar in the body and too many of them will strain the adrenals as well as lead to neurotransmitter imbalances and upset hormone levels.
The best adrenal fatigue diet is a slightly modified version of the Paleolithic diet, which includes a generous amount of animal protein and fat, a moderate level of low carb vegetables, and a small amount of fruit, nuts, and seeds. Grains, beans, and potatoes should be restricted or avoided altogether. Dairy should be restricted to butter, ghee, and heavy cream, if tolerable. This will help provide a nice even amount of energy throughout the day and give the body the types of foods it was designed to eat.
Comprehensive Adrenal Fatigue Treatment
Adrenal fatigue treatment may consist of providing adrenal support through a variety of lifestyle changes, diet, nutritional supplements, and adrenal hormone replacement. You can learn the basics for recovery in my pre-recorded webinar, Adrenal Recovery Basics.
However, the steps one takes for recovery depends on what phase of adrenal fatigue you are in and how your body responds. Once again, it is really important to seek the guidance of a skilled physician with expertise in adrenal fatigue, who also understands the advanced stage of adrenal exhaustion.
For the person who is in the stage of adrenal exhaustion, it is crucial that they take the right steps in the right order. The dosage of nutrients must be correct for their body and herbs, nutrients, or glandular that stimulate the gland will only make matters worse. The healing plan will be unique for each person depending on their situation.
For example, someone who is in the early stages of adrenal fatigue may find an adrenal glandular to be beneficial, but someone who is already in the adrenal exhaustion phase is likely to have an exacerbation of symptoms from a glandular. People in the early stages of adrenal fatigue will need a different dosage of vitamin C and pantethine than a person with adrenal exhaustion. Someone in the earlier stages may benefit from licorice, while the person in exhaustion will become more incapacitated.
- Reduce excess stress and rest as much as possible. This is the crucial first step.
- No caffeine
- No alcohol or psychotropic drugs (including medical marijuana, cannabis, etc.)
- No sugar, white flour, or refined foods.
- Get regular exercise, but make it mild and gentle.Exercise that is too demanding, extreme, or strenuous will put too much stress on the adrenals and deplete them further. However, mild exercise like a gentle walk, yoga, Tai Chi, or Qigong can help them function better.
- Get adequate sleep and go to bed no later than 11 p.m. The adrenals do the majority of their repair work between the hours of 10 p.m. and 1 a.m.
- Use stress relieving and relaxation activities on a regular basis like mindfulness-based meditation, deep breathing exercises, soothing music, journaling, time with nature, art, or any other outlet for creativity to provide adrenal support.
- Add 1/8 to 1/4 of a teaspoon of sea salt to your drinking water, but not if you have high blood pressure or experience negative symptoms when this is tried. This helps address low levels of aldosterone.
- A therapeutic dose of hydrocortisone is often used for adrenal fatigue treatment to support the adrenal glands. First, a saliva test is performed to measure your cortisol levels in the morning, noon, afternoon and evening. Then, depending on what your results are, cortisol is supplemented. Usually, five or ten mg of cortisol is administered for each time slot that indicates a low output of cortisol. Using hydrocortisone in low-level therapeutic dosages such as this does not have the negative consequences on health that other cortisone products like prednisone have. Natural cortisol is another option as well. However, it's important to be aware that taking cortisol does not heal the glands, it works like a band-aid, and the adrenals can continue to deteriorate if they are not nurtured back to life.
- There are numerous nutritional supplements and herbs that are frequently used to provide adrenal support. It will vary from practitioner to practitioner and person to person who has adrenal fatigue. The two most important nutrients for anyone with adrenal fatigue or adrenal exhaustion are vitamin C and pantethine. Pantethine is a more absorbable form of pantothenic acid. Vitamin B6 is also crucial, as it helps regulate adrenal hormones. Others that may be used by other practitioners include the rest of the B vitamins, d-ribose, licorice, Siberian ginseng, Rhodiola Rosea, adrenal glandular, magnesium, chromium and glutamine. However, many of these substances can be way too stimulating for many people, and I discourage the use of ginseng, licorice, glandular, adaptogens, and d-ribose.
- It's important to note that although d-ribose is considered to be one of the most beneficial nutrients for someone with adrenal fatigue or adrenal exhaustion, that for some people it feeds Candida and thus can't be taken. You will find that many of the specialists in adrenal fatigue will claim that d-ribose will not feed Candida, but that is not true. In theory, it is not supposed to, but what occurs in real life is often different than theory. If someone tells you otherwise, they do not have a thorough understanding of Candida. D-ribose can and does feed Candida for some people, it depends on the strain of yeast one has and the level of overgrowth. That was my experience personally. Some physicians will recommend people with Candida cut their dosage of d-ribose into several small doses throughout the day and be sure to take it with a meal. That didn't work for me. Even 1/16 of a teaspoon on a full stomach feeds my Candida. However, for some people that do seem to work. Additionally, d-ribose set off my stress response system, severely.
- You should also be aware that doses of vitamin C and pantethine will be much higher than the doses that the average person will take. A form of vitamin C called liposomal vitamin C is recommended because it has a much higher rate of absorption. It is believed that only about 10% of traditional vitamin C makes it into the cell, while liposomal has an absorption ability of about 95%. However, most liposomal vitamin C contains soy derivatives, so if you are severely estrogen dominant or have problems with soy, you may not be able to tolerate it. Additionally, soy contains a variety of naturally occurring toxins that can be harmful to the thyroid, pancreas, and gastrointestinal tract and should be avoided. There are a couple brands on the market that don't have soy, so you should use one of those. However, liposomal is usually high in phosphatidylcholine, which can cause overstimulation to the sympathetic nervous system in some people and it is often combined with a variety of other ingredients like peppermint, orange oil, or alcohol, which is problematic for many severely sensitive people.
- Ascorbyl palmitate is another recommended form of Vitamin C because it is more absorbable than ascorbic acid. Ascorbyl palmitate is fat soluble, which means it can be stored in the fat and called upon throughout the day as needed. Ascorbic acid is water soluble, which means it must be used by the body at the time of consumption and any excess is flushed out with urination. My body responded very well to ascorbyl palmitate. A combination of all three forms is recommended to keep a high flow of vitamin C throughout the body at all times.
- There is disagreement in the natural health field on whether glandular should be used. Some experts feel they are harmless and helpful, while others feel they can lead to dependence. So this is something you want to take into consideration when making a decision. Additionally, people with advanced adrenal fatigue, or those who have adrenal exhaustion, often feel worse when taking glandulars as well as a variety of the other natural supplements that are supposed to give the adrenal glands a boost like ginseng, licorice, DHEA, etc. This has been my experience personally in this area as well. I have too much norepinephrine, so taking a supplement that stimulates this hormone only makes me feel worse. Glandulars or any of the herbs that work by stimulating the gland, completely incapacitate me. Always listen to what your body tells you.
- Restoring balance to the autonomic nervous system, so that the adrenal glands are not under constant duress, is the key component for recovery. This process can be significantly enhanced with a limbic system retraining program.
Another very important point to keep mind is that any adrenal fatigue or exhaustion treatment protocol one uses should be individualized, based on the unique needs of each person. What works for one person, may be harmful to another. It is always recommended that you work closely with a knowledgeable healthcare provider who can help you determine which steps are best for you to take and find the right balance of nutrients and supplements needed for your biochemistry. The sicker you are, the more important this is.
Contact Me Today for personalized guidance on your recovery path.
The road to recovery for adrenal fatigue is usually not a fast one or a straight and narrow path. It takes time and commitment. Anywhere from six months to more than five years, depending on the severity. There are usually a variety of setbacks and progress is a slow process. This is especially true if you are in the adrenal exhaustion phase. Furthermore, once you have had severe adrenal fatigue, you typically must be very careful and nurturing for the rest of your life.
Do You Have Adrenal Fatigue?
Most mainstream doctors (including endocrinologists) are not capable of diagnosing adrenal fatigue because of the way they have been trained. They have been schooled to only look for the most extreme form of adrenal malfunction, known as Addison's Disease which occurs when there isn't enough cortisol; or Cushing's Syndrome, which occurs when there is too much production of cortisol. They use blood to look at cortisol levels, which does not give us a true read and an ACTH test that only considers the top and bottom two percent of the bell curve to be outside the normal range, while adrenal dysfunction occurs after fifteen percent of the mean on either side. Thus, most people with adrenal fatigue will be told there is no problem since they are not within the two percent.
One of my doctors showed me a great little trick to test for adrenal fatigue. Take your blood pressure while sitting down and record the numbers. Keep the cuff around your arm and stand up. Take your blood pressure again immediately after standing. In a healthy person, the blood pressure will rise when they stand. In a person with adrenal fatigue, the blood pressure will drop when they stand.
However, the most common and reliable method for testing the adrenals is with an adrenal stress test, also known as the cortisol saliva test. Blood tests are not reliable because they only test for "bound cortisol" while saliva tests for what is free and circulating, which is what we need to know. Many people will test normal on a blood test, but below normal on saliva testing.
Saliva testing can be done very easily with a simple at-home test kit. You collect your saliva, mail it back to the lab, and they send you your results.
Hormones and Neurotransmitters
The adrenal glands work in conjunction with hormones and neurotransmitters. When there is an imbalance or malfunctioning in one of these areas there is usually a problem in the other areas, so it is recommended to evaluate these levels as well. Adrenal glands need balanced hormones and neurotransmitters to function properly and neurotransmitters are also impacted by hormone levels and adrenal glands. It's a reciprocal relationship and to restore balance to one, all need to be addressed. It is absolutely critical to restore balance to GABA and dopamine, and histamine when dealing with adrenal fatigue.
Dr. Wilson. https://www.adrenalfatigue.org/ and Adrenal Fatigue: The 21st Century Stress Syndrome
Dr. Michael Lam https://www.drlam.com/