Diagnosing Adrenal Fatigue:
To diagnose adrenal fatigue, you need to take the “Adrenal Stress Index” (ASI), provided by Diagno-Techs, Inc., a clinical and research laboratory in Washington state. The ASI is a test that will be shipped to you for you to complete at home and return. The results and interpretation will be mailed to you in a couple weeks.
Evaluating Test Results:
After receiving your test results, you can evaluate your stage of adrenal fatigue at this website.
Other Recommended Tests:
In addition, I recommend contacting your physician and requesting the following lab tests:
- Thyroid Testing: TSH, T4, T3, free T4, free T3
- Antibodies to thyroid (if indicated)
- Fasting Insulin
- Hemoglobin A1C
- Complete Blood Count
- Complete Metabolic Profile
This is a helpful website for understanding the results of lab tests.
The adrenal glands control every part of the body, yet in our culture, the adrenal glands have taken quite a beating. Healing from adrenal fatigue is difficult and requires some lifestyle changes. However, I’ve done it and I know you can, too! I’ve outlined steps you can take to begin feeling better right away.
First, why have my adrenal glands been damaged? Secondly, how do exhausted adrenal glands affect me? Finally, what must be done to recover? We will discuss all these topics.
Why Have My Adrenal Glands Been Damaged?
The causes of adrenal fatigue are numerous. Let’s think about a tiger in the wild. He must use great amounts of his adrenal resources as he crouches in the grass, waiting to pounce on his prey. Then he must leap out suddenly and possibly chase his prey for long distances before finally attacking and killing it. If I did all that, I’d be in bed for a long time!
Scientists have done research on the adrenal glands of wild tigers. They have found that their adrenal glands are normal sized, are healthy, and are able to adapt to any dangerous situation at a moment’s notice.
However, if you have adrenal fatigue, your adrenal glands are probably enlarged, do not produce the correct amounts of hormones to respond to stress, and are degenerating rapidly.
So can stress be the cause of the problem? It doesn’t seem likely, since stress is a normal part of life and our bodies were created to deal with it effectively.
We have some differences from that wild tiger. First of all, we generally don’t eat a diet that is suited to our bodies. When our bodies cannot digest our food properly, the undigested food (commonly called a toxin) must be cleaned out of our systems or we will die. Glands that were created to serve other purposes must be called upon to clean up the garbage instead. This wears them out quickly! Secondly, since we are created beings with a soul and not just animal instinct, we must take our emotions and spirits into account when we deal with stress. We have a free will. We can make choices. We don’t always make the best choices!
How Do Exhausted Adrenal Glands Affect Me?
How do exhausted adrenal glands affect me? What happens when adrenal glands are not functioning properly? This chart, from the June 2002 issue of Addison News, explains it very well. (I put a copy of this chart on my kitchen wall for quite some time, so that I could see it often and learn it well.)
As you can see, the adrenal glands affect four major areas of your body: Your liver, your digestion, your kidneys, and your heart. (You should also be aware that when your adrenal glands aren’t functioning properly, no other glands in your body will produce the proper level of hormones. This can dramatically affect how you feel!)
Since these four areas of your body are affected the most, we will start here when discussing how to feel better.
The following is from the website http://www.cushings-help.com:
Symptoms of adrenal exhaustion:
- profound weakness
- slow, sluggish, lethargic movement
- low blood pressure
- high fever
- chills shaking
- confusion or coma
- darkening of the skin
- rapid heart rate
- joint pain
- abdominal pain
- unintentional weight loss
- rapid respiratory rate
- unusual and excessive sweating on ace and/or palms
- skin rash or lesion may be present
- flank pain
- appetite loss
Signs and tests:
- An ACTH (cortrosyn) stimulation test or ASI saliva test shows low cortisol. (Anne’s Note: Adrenal fatigue often begins with test results showing high levels of cortisol. Read this article for more information.)
- The cortisol level is low.
- The fasting blood sugar may be low.
- The serum potassium is elevated.
- The serum sodium is decreased.
This disease may also alter the results of the following tests:
- sodium, urine
Emergency Treatment: In adrenal crisis, an intravenous or intramuscular injection of hydrocortisone (an injectable corticosteroid) must be given immediately. Supportive treatment of low blood pressure is usually necessary. Hospitalization is required for adequate treatment and monitoring. Low blood pressure may be treated with intravenous fluids. If infection is the cause of the crisis, antibiotic therapy is indicated.
Expectations (prognosis): Death may occur due to overwhelming shock if early treatment is not provided.
Complications: shock, coma, seizures
Notice that adrenal fatigue causes four main problems:
- Low liver function, which causes low blood sugar. Try to eat a combination of protein and carbohydrates every few hours, especially before bed. I have found that a good ratio for me is 1 gram of protein and 1 gram of saturated fat for each 2 grams of carbohydrates I eat. (This is not the typical American diet!) Do you wake in the middle of the night, maybe with bad dreams or sweating? If so, eat something, because it means your sugar is dropping. That alone will cause very low energy. I also have this trouble in the morning, so I basically drink a big glass of milk and eat 2 scrambled eggs about 15 minutes after getting up, even if it makes me feel queasy. Then I eat breakfast AGAIN with the kids whenever we get it ready. It helps my energy levels a lot.
- Low digestive enzymes, which causes indigestion, nausea, maybe even diarrhea. Cortisol, one the major hormones produced by the adrenal glands, controls the manufacture of digestive enzymes in the pancreas. If you’re not producing enough cortisol, you’ll have a difficult time digesting your food. (Symptoms include bloating, abdominal or chest pain, nausea and diarrhea.) Taking digestive enzymes every time you eat is one of the smartest things you can do! (See supplements.)
- Loss of water and sodium from kidneys. My urine has a funny smell when I’m too tired. I drink a cup of water (or milk or whatever) with a teaspoon or so of sea salt (“Celtic Sea Salt”). I’ve also been known to binge on Fritos! Not so good! But I crave salt when pregnant or tired, and I wonder if you do, too. If so, listen to your body and get more salt and fluids in you. Dehydration is dangerous (life-threatening!) when your adrenals are fatigued. Do not ever allow yourself to become dehydrated. Be especially careful in hot weather, when tired, or when you have the stomach flu. If you cannot correct it at home, do not hesitate to go to the emergency room.
- Irregular heart, which shows up in low blood pressure. Take and compare two blood pressure readings—one while lying down and one while standing. Rest for twenty minutes (lying down) before taking the reading. Stand up and immediately take the blood pressure again. If the blood pressure is lower after standing, your adrenal glands are in trouble! The degree to which the blood pressure drops while standing is often proportionate to the degree of hypoadrenalism. (Normal adrenal function will elevate your BP on the standing reading in order to push blood to the brain.)
If you don’t have a blood pressure cuff, I would HIGHLY recommend it. I have a wrist cuff, automatic, from Wal-mart, and it’s easy. Another note: normal pressure is 120/80. Mine was going as low as 85/55. So how far you are from normal tells you a lot. Also, if the cuff you use keeps track of your pulse, all the better. When your adrenals are fatigued, your pulse will shoot quite high after you stand up, in an attempt to get your blood moving. So a low blood pressure with a high pulse tells you a lot.
How can we recover? First, we must rest. If the adrenals are to recover, you must receive a great amount of rest. Only during rest can your adrenal glands regenerate. This is true of any organ, but it is particularly true of the adrenal glands.
One doctor puts it this way.
Normally the adrenal glands regenerate during a night’s sleep the vitality they expended during the previous day. They are then ready the following morning to go through another day of equal rigor. In hypoadrenalism, the glands are exhausted. They have expended more vitality than they can make up for in a single night’s sleep. Thus, if they are going to return to normal, they must regenerate more than the body expends. If the glands can’t do this, they won’t recover. They may not get worse, but they won’t get better. For this extra regeneration, rest is required–much more than the usual eight hours a night.
The example I usually give my patients compares them to their bank accounts. The reserve of the adrenal glands is like money in a bank account held for emergencies. Let’s say you have a thousand dollars in the bank, and every night you deposit a hundred dollars. If during that day, you spend a hundred dollars, the reserve fund is still intact.
In the same way, the adrenal glands have a considerable reserve held for emergencies, and they are able to regenerate (deposit money) at night while they rest. During the day, if we expend no more energy (money) than the adrenals are able to build up at night, we still have our adrenal reserve (the thousand dollars). If an emergency arises and we must use some of the thousand dollars, we must do one of two things. We must either make more money or spend less so we can deposit more into the bank account to build it up to its reserve level. This same philosophy works with the adrenal glands.
When the adrenals are exhausted, to produce regeneration it is necessary to expend less energy during the day than the adrenals build up during rest. In this way, some of the energy the adrenals build during this rest can go toward building their reserve. Source
Let’s talk about some kinds of stress that draw from our adrenal bank accounts. To simplify things, I like to think of three kinds of stress: physical, mental, and emotional. I assign one point to each physical stress, two points to each mental stress, and three points to each emotional stress.
When I sleep each night, my body deposits “points” back into my adrenal bank account. At first, my body deposits very few points because so much energy is needed to heal. After awhile, I find that more points are deposited and I can “spend” more points the next day. But in my opinion, I’ll probably have to be aware of “points” and how much I’m “spending” for the rest of my life, if I wish to maintain my health.
Let’s talk about some common causes of stress and some ways to overcome them:
Eating food that must be digested = 1 point
Eating food is probably the largest strain on your body. It’s supposed to digest your food! You can’t obviously just stop eating (although lack of appetite is common with adrenal fatigue).
However, your body uses enzymes to both digest your food and to heal. Therefore, your body can manufacture two types of enzymes: digestive and metabolic. Unfortunately for you, adrenal hormones are necessary for the manufacture of both types of enzymes. This is why you would immediately die if you didn’t produce any adrenal hormones! This is also the largest reason you feel so terrible right now.
You can supplement with adrenal hormones from animals (see discussion below), but if you use up all of the supplemented hormones to simply digest your food, you will have nothing left with which to heal your body.
A better way is to eat food that already contains some digestive enzymes, so that your food is simple for your body to digest and requires fewer resources. Now you’ll have more energy left to heal!
How do you do this? First of all, there are two kinds of food that you need to avoid at all costs, because they are a huge drain on your adrenal glands. These two kinds of food are simple sugars and processed foods. (See article called “What You Should Know About Your Glands.”)
Simple sugars are any foods that contain sugar, corn starch, and food ending in the suffix –ose (such as fructose, dextrose, etc.). You will need to avoid fruit juice, soft drinks, syrups, and most desserts. Watch out for hidden sugar in packaged food. Learn to read ALL labels.
Sugar that is okay in small amounts includes “unrefined sugar” (not raw sugar) and raw honey (it will say “raw” or “unheated” on the label, or else don’t use it!). What is a small amount? About the most I can get away with is a teaspoon in a cup of tea or coffee, or a spoonful in my breakfast cereal. You will have to pay attention to how you feel to see what you can handle.
Simple sugars are also found in many grains and vegetables, such as bananas (and most other fruit), mashed potatoes, carrots, beets, and bread. You can handle more of these if you include plenty of butter or coconut oil. Simply keep in mind the ratio of 1 gram protein/1 gram saturated fat/2 grams carbohydrate.
Processed food has been stripped of most of its nutrients and all of its enzymes. Often, harmful chemicals have been added. Any food that has been heated above 118 degrees will not contain any enzymes. Fresh vegetables and fruits from your garden are excellent. Unpasteurized milk from grass-fed cows is very healing. Boxed and canned foods from the store are not. Obviously, you’ll have to eat some cooked food, but you need to add enzymes to your diet whenever you do. I have also learned to cook a little differently, using methods from a book called Nourishing Traditions, by Sally Fallon. I highly recommend this cookbook!
Fatigued adrenal glands need plenty of nutrients:
- I recommend high-quality saturated fat in the form of coconut oil, butter, and cod liver oil. (Use 1 tablespoon of cod liver oil per day. It can be ordered from many sources, but I recommend Radiant Life Wellness Catalog for this and many other fine products.)
- I recommend plenty of vitamin A. This can only be obtained from animal sources, such as beef, eggs, milk, and butter. Beta-carotene, such as found in carrots, must be converted to vitamin A by your body. If your adrenals aren’t healthy, you won’t be able to make this conversion! Therefore, eat plenty of animal foods! (Use those enzyme capsules to help you digest them.)
- I recommend plenty of the B vitamins. These can be obtained from grains, such as wheat and brown rice and oatmeal. However, you will have difficulty digesting these. The cookbook Nourishing Traditions can explain how to prepare them properly so that you can nourish your adrenal glands.
You are probably losing sodium in your urine and retaining potassium. Therefore, you need plenty of salt (preferably celtic sea salt) in your diet. If you are craving salt, eat a teaspoonful of salt straight from your hand, with some water or milk.
The rest of my recommendations for diet can be found in the book Eat Fat Lose Fat, by Sally Fallon. This book is not only about weight loss. I recommend the chapter on Health Recovery, as well as the specific diet and recipes for Health Recovery in the back of the book.
Not getting enough rest = 1 point
Adrenal hormones are in control of circadian rhythms, or the rhythms of sleep and wakefulness that you go through each day. For this reason, it’s often hard for people with adrenal fatigue to sleep. Others have trouble waking up!
Circadian rhythms are controlled by the amount of light received by your eyes, which in turn regulates the production of a hormone called melatonin. This hormone goes on to affect all glands of your body, including your adrenal and thyroid glands. (Please read the article “Light and Dark.”) In a nutshell, you should…
- Sleep in as close to complete darkness as possible. If you must get up in the night (to use the restroom, etc.), try to stay in the dark.
- Get as much sleep as you can. Go to bed early. Sleep late. Take naps.
- As you start to recover, rise in the morning with the sun. This will help you reset your circadian rhythms.
- When you’re tired, rest. Learn to pay attention to how you feel and rest before you crash. Your emotions are good indicators of how much rest you need. If you feel angry, anxious, or ready to cry, you have probably overdone it and should try to take a nap.
- Take one day out of every seven to completely rest. I personally rest from sundown Friday to sundown Saturday. By rest, I mean that I do no cooking, cleaning, laundry, gardening, heavy thinking, shopping, or any other work. Instead, I read, put my feet up, play games with my children, laugh and enjoy my family. I cook ahead for that day so that I have an entire 24 hours off from my responsibilities.
3. Replace adrenal hormones
Requiring my fatigued adrenal glands to produce hormones = 1 point
In addition to sleep, you need other ways to rest your body. Your adrenals are overworked. In the past, I used a product called IsoCort, but it is no longer available. For this reason, we are now recommending Adrenal Support from Nature’s Sunshine, or Adrenal Cortex from Source Naturals. For further ideas of how to support your adrenal glands, see http://www.stopthethyroidmadness.com/adrenal-wisdom.
Too much physical exertion = 1 point
You just aren’t going to be able to exercise much at this point in your life. You probably already know this! However, adrenal fatigue affects your circulation, so you need to move at least a little bit. (Contraction of the muscles in your legs, by exercise, for instance, helps your blood circulate through your veins.) A short, slow walk is best. Don’t walk on hot or very cold days. Don’t overdo it! Don’t walk too far before realizing that you have to walk back! It’s best to walk with someone else at first, in case you get too tired.
Remember that laundry, cooking, cleaning, taking care of children, farm chores, gardening, shopping, and going to church are also forms of exercise. Pay attention to how you feel and stop before you get too tired. Learn to delegate household chores to others so that you can get well.
Over committing = 1 point
Most people who have adrenal fatigue have “driven” personalities. I’ve noticed that we tend to be passionate people who want to make a difference in the world. We tend to be perfectionists, at least with ourselves. We love to be busy, and we thrive on helping others. These are great characteristics, but it’s difficult to heal when we over commit.
Sometimes it’s hard to adjust to the fact that adrenal fatigue affects every area of my life. However, I have learned that as soon as I overdo it, I fall right back into feeling sick.
6. Injuries, Sickness, Travel, etc.
All forms of physical stress = 1 point
Your adrenal hormones handle all types of physical stress. If you are not manufacturing enough hormones (because your glands are too fatigued), then you will simply not handle stress well.
(By checking your diet, I mean that you should check to be sure you have not had too much sugar or processed food. When feeling too stressed, I will drink plenty of unpasteurized, farm-fresh milk or eat vegetable soup with plenty of zucchini, since these foods are easy to digest and full of nutrients.)
Here are some examples of physical stress:
- A sore throat, runny nose, or achiness – you’re getting a cold or the flu! Be especially careful! Dehydration is your biggest enemy here. Always stress dose!
- A cut, burn, or other injury
- Other sickness
- Pregnancy, Childbirth, Breastfeeding
Mental and Emotional Stress
All forms of mental stress = 2 points
All forms of emotional stress = 3 points
I have trouble sometimes deciding if something is a mental or emotional stress. Mental stress would include making shopping lists, planning menus, trying to remember things, doing a lot of reading, balancing a checkbook, writing a letter, or talking on the phone. These are each 2 points. If my emotions are included in these things, I must count them as emotional stresses instead. For instance, if money is tight and I’m worried about finances as I balance my checkbook, it’s 3 points. If I’m talking on the phone with someone and our relationship is strained, it’s 3 points.
Other types of emotional stress include being in crowds of people, fear, worry, fighting with people, anger, etc. Simply worrying about being sick or dying is an incredible emotional strain.
While I might know in my mind that things are outside of my control and that therefore I shouldn’t worry about them, when my adrenal glands are fatigued, anxiety is very difficult to control. This is because the adrenal hormones regulate my feelings to some extent. It can be a vicious cycle. I feel depressed or anxious or angry, then I react poorly, then I’m more depressed or anxious or angry, straining my adrenal glands and making me feel even worse.
Several things are urgently important to bring me out of this.
- I may need to “stress dose.” As you’re beginning to heal, this is the key to feeling better. As you feel better more consistently, you’ll need to stress dose less often. You can learn to handle your emotions constructively later; for now, you need to rest your body by supplementing with adrenal hormones. If your adrenals are the cause of your feelings, you should feel better within 10-20 minutes.
- Realize that things may be out of your control, but they’re never out of God’s control. Learning to take all my anxiety to Him in prayer is critical. I have also researched Bible verses that are comforting, and I will read or recite them over and over when I am feeling at my lowest. I have this ready ahead of time, knowing that I’ll need it someday! See John Piper’s book sample, Future Grace.)
- Learn to depend on others. My children know that if I start to cry and cannot stop, they are to call a family friend to our home right away, in addition to asking me to “stress dose” immediately. We keep this friend’s phone number on our wall where anyone can find it. I have also learned that if my husband or children tell me to go to bed, I should not take it personally. I must tell myself that they are only concerned about me, love me, and want me to feel better. I must not feel guilty or lonely or neglected. I must simply take a nap and trust that everything will be better in a few hours.
- God calls fear a sin. How seriously do I take this? Search His Word for what it says about fear and its consequences. For instance, if fear is a sin and brings a curse, read Deuteronomy 28 and determine if any the of the curses mentioned fit your life. Allow the Holy Spirit to search your life and teach you! Here is an article to get you started: “How Fear Affects the Body.”
How will you know, objectively, that you are getting better? How will you know that this plan of action is helping? There are five indicators of health that you need to monitor.
- Body Temperature. You can determine your thyroid and adrenal status by using a temperature graph. You simply take your temperature 3 times a day, starting three hours after you wake up, and every three hours after that, to equal three times. (If you have eaten or exercised right before it’s time to take your temperature, wait 20 more minutes.) Then average them for that day. Do this daily.If your average temperature is fluctuating from day to day more than 2/10 of a degree, you need more adrenal support. If it is fluctuating but overall low, you need more adrenal support and thyroid. If it is fluctuating but is overall close to 98.6, you just need adrenal support. If it is steady but low, you need thyroid support only. (We note that mercury thermometers are the most accurate, but I’ve just used my digital with fresh batteries, and it has been reliable enough for my purposes.) At the following link, you’ll find a graph that you can use, as well as an example graph. (See article called “Metabolic Temperature Graphing”.)
- Blood pressure. As described before, low blood pressure is a sign of adrenal fatigue. Normal blood pressure is 120/80. Anything lower than this is a sign of a problem. In addition, if your blood pressure falls rather than rises when you stand, you have a more serious adrenal problem. Monitor this daily and record everything.
- Eyes. Another test measures the eyes. Adrenal hormones are needed to regulate the dilation of your pupils. Ask your spouse or a friend to help you with this. From the side (not the front), shine a bright light like a flashlight or penlight towards your pupils and hold it for about a minute. Carefully observe the pupil. With healthy adrenals, your pupils will constrict and will stay small the entire time you shine the light from the side. In adrenal fatigue, the pupil will get small, but it will soon enlarge again or obviously flutter in its attempt to stay constricted.Also, are you very sensitive to bright light? That could be a sign of adrenal fatigue. This can also be true if you have searing headaches along with the sensitivity to light. Write down your symptoms.
- Urine. Since adrenal hormones control your kidneys and circulation, many people with adrenal fatigue notice a strong, bitter smell to their urine. Many have pain upon urination, mimicking a urinary track infection. If you notice these symptoms, record them (and be sure to increase your salt and fluid intake to avoid dehydration).
- Other symptoms. Be sure to record all symptoms that are unique to you. These may include trembling, weakness, shortness of breath, pain in your back or arms, or emotional problems (such as anger or crying). Click here to print a graph for recording symptoms. Once each week (I do this on Mondays), rate your symptoms from 1-10 (with 10 being worst). You should see your symptoms decreasing from week to week. If they do not, evaluate your lifestyle for areas that may need to change.
I have given you a lot of information! You will probably not be able to remember all of it. You should have someone else read this, too, so that they know how to help you. I am including a checklist of things you need to do, a list of books that are urgently important to read, several articles that you need to read, and a list of supplies you will need to purchase. Please consider investing money in the supplies and books. They will help you heal! The expenses you will have on a continuing basis are marked so that you can plan your budget accordingly.
If you have questions as you read, write them down in your journal.
- Make a list of all symptoms you’re currently experiencing so that you can remember them later. Use the list above to get started. Add any others you think of.
- Order helpful supplements immediately.
- Obtain the supplies you will need.
- Put a list of emergency procedures and phone numbers in a prominent place in your home.
- Contact close friends who can help in emergencies.
- Begin changing your diet by eliminating simple sugars and eating a healthy ratio of 1 gram protein and 1 gram saturated fat for every 2 grams of carbohydrates.
- Begin keeping a journal of all your symptoms, of your body temperatures, of your blood pressure, and of all the food you eat.
- Order the books on the reading list and begin reading them as you can.
- Print the “Symptoms I’m Having Now” Worksheet
- Print the “Diet Diary”
Note: Items marked with a * will be needed on an on-going basis.
Foods and Supplements:
- Celtic Sea Salt (Radiant Life Catalog)
- Premier Quantum Norwegian Cod Liver Oil (Radiant Life Catalog) – $15, liquid or capsules, or Super Omega-3 EPA capsules *
- Enzymes *
- Adrenal Support or Adrenal Cortex *
- Master Gland *
For Monitoring Health:
- Blood Pressure Cuff (from pharmacist) – usually less than $50 for digital, wrist cuff
- Thermometer (I prefer digital, from pharmacist) – usually less than $5
- Mastering Your Life, by Gerald E. Poesnecker (Clymer Healing Research Center, 215-536-8001) – $12
- A More Excellent Way, by Henry W. Wright (Be in Health, http://www.beinhealth.com, 1-800-453-5775) – $24.95
- Nourishing Traditions, by Sally Fallon (Radiant Life Catalog) – $25
- Eat Fat Lose Fat, by Sally Fallon (Radiant Life Catalog) – $15
- Managers of Their Homes, by Steven and Teri Maxwell ($25, 913-772-0392)
- See also our list of books and websites.