Adrenal Fatigue & Adrenal Insufficiency

The Adrenal GlandsAdrenal glands
Gram for gram, the adrenal glands receive more blood flow than any other part of the body–including the heart and the brain. The body is an efficient machine, so this relatively massive dedication of blood flow is an indication of how important these often tiny organs are. Theysit on top of your kidneys weigh in at a mere 3-5 grams each and measure are 1/2″ tall and 3″ wide.

The Adrenal Medula & Cortex
Your adrenal glands have two layers that secrete different sets of vital hormones. The outer layer of the adrenal gland (the adrenal cortex) secretes steroid hormones which are made from cholesterol. Cortisol is, by far, the major hormone product of the adrenal cortex. It is called a “glucocorticoid” because of it’s effects on raising blood sugar (glucose).

Healthy cortisol levels have a “diurnal” cycle, with normal levels being highest around 7AM and lowest levels occurring around midnight. This morning cortisol boost is intended to wake you up with plenty of blood sugar and blood pressure. If you wake up feeling unrested, groggy and wrecked there may be a problem with your sleep or your Adrenal glands may be fatigued or exhaustred. That’s what this article is about.

The Diurnal Cortisol Patterncircadian-rhythm-cortisol

The inner layer (the adrenal medulla) secretes epinephrine (adrenalin) and norepinephrine. These two immediate “fight or flight” hormones are released in large amounts in response to sudden stressors, low blood sugar and exercise. Together epinephrine and norepinephrine raise blood pressure, mobilize glycogen and fat stores to increase your blood sugar. They aslo dilate blood vessels in the large skeletal muscles to prepare them for major action.

The adrenal cortex also secretes aldosterone (which helps raise blood pressure by preventing sodium loss in sweat and urine) and “androgen” hormones such as androstenedione and DHEA (dehydroepiandrosterone) which give adults secondary sex characteristics of body hair, increased muscle mass, and libido. DHEA is also the primary building block for the major sex hormones: estrogen and progesterone in females; and testosterone and dihydroxytestosterone in males. If DHEA levels or testosterone levels are low (in both men and women) this alone could be a major cause of depression, fatigue and decreased vitality, and libido.

Cortisol: The Master Stress Hormone
Like epinephrine and norepineprine, cortisol is also released in response to stress. It gives the body an extra energy burst as well as making the body more tolerant to pain and inflammation—handy if the stress is likely to cause physical trauma as was so often the case before modern times. In moderation, cortisol bursts temporarily increase immune system function, help maintain higher blood pressure and regulate insulin levels. Unfortunately, this system was well designed for our hunter-gatherer ancestors for whom stress was probably rarer, realer and more short-lived.

The body is not able to distinguish between real stress and the “modern emergencies” that include: urban noise, phone calls, dinging email and IM alterts, high-speed transportation, modern work, modern relationships, and the crush of people we experience every day in modern cities. With this virtually constant stress, the adrenals can easily get stuck in high cortisol production. Modern humans experience near-constant stress, and so high cortisol levels have become what we now mistakenly call “normal.”

Pain is a big stressor. If you have chronic pain from injuries, arthritis, or nerve damage you are likely to have especially high cortisol levels. Frequent lack of adequate sleep also raises cortisol release, and excessive cortisol itself disrupts normal sleep patterns, creating a propensity toward staying up late and feeling very tired in the morning–no matter how much sleep was had. Because a tired person does not handle stress as well as a well-rested person, the cycle can easily snowball and get worse. Overexercising can also be a cause of sustained excess adrenal output.

The adverse effects of chronically high cortisol levels contribute to all of the modern health epidemics: diabetes, high blood pressure, heart disease, cancer and obesity. Chronically high cortisol levels also causes bone thinning (osteoporosis) and make muscles and connective tissue (tendons, ligaments, inter-vertebral discs) weak and fragile. High cortisol also slows cell regeneration and with it the body’s ability to heal and recuperate. Long-term, high cortisol also depresses the immune system–which can make one more susceptible to colds, flus, cancer, and chronic infections like intestinal candida and Epstein-Bar virus (EBV).

Chronically high stress and cortisol levels are also implicated in autoimmune disease and food allergies. Cortisol also hinders digestion by diverting blood flow away from the digestive tract and otherwise slowing the regeneration of stomach and intestinal linings. Long-term high cortisol also decreases cellular insulin sensitivity which is why metabolic syndrome, type II diabetes and “truncal obesity” (abdominal weight gain) are so predominant today—even in children.

Our modern lives scenario odepend on our tiny adrenal glands  producing cortisol endlessly. The problem is that they can’t, and the picture gets even worse when the adrenal glands begin wear out.

The Progression of Adrenal Fatigue:

  1. Normal: Homeostasis
  2. Acute Stress: Resistance & Adaptation
  3. Adrenal Fatigue: Compensation
  4. Adrenal Failure/Exhaustion: Failed Adaptation


4-Sage Adrenal Stress Picture

Adrenal fatigue occurs when the adrenal glands are no longer able to adequately hormonally respond to stress. Cortisol, DHEA, and other hormones are produced in abnormal amounts (either high or low) and adrenal fatigue sufferers experience many of the problems that come with chronically high cortisone levels. Adrenal fatigue is usually caused by chronic stress, whether that stress is mental, emotional, physical, or environmental (e.g. infection, exposure to toxins, nutritional deficiency).

Adrenal fatigue can be described as occurring in four distinct stages: defined in terms of hormone output. Although poorly recognized by the allopathic medical system, adrenal fatigue can be easily measured with blood or saliva tests. Below are the four stages in detail:

Stage 1: Normal Adaptation
This is what we would call a normal daily adrenal pattern. A result in the yellow zones would indicate some degree of dysfunction and a result in the red zones indicates a severe dysfunction.
Normal Cort

Stage 2: Resistance to Acute Stress
This is a healthy reaction in which the body responds to stressors, and mounts a strong cortisol response to overcome them. The adrenal glands increase their output of stress-mediating hormones including cortisol and DHEA and at this stage the output is well within the gland’s normal capacity.  Blood pressure and blood sugar and LDL cholesterol might be increased.

My front-line therapy for adrenal Stress is L-Theanine, a non-essential amino acid with a variety of health benefits. It is abundant in green tea. It relaxes the mind and body by increasing GABA and glycine levels in the brain. GABA and glycine are inhibitory neurotransmitters that work to offset overactive excitatory neurotransmitters. Theanine promotes a state of relaxation and calm and thereby, reduces stress, anxiety, and ADD. I recently discovered that chewables or lozenges were VERY effective. Click the picture on the left to buy my preferred brand.

Elevations in cortisol output may be generalized or limited to just the morning, mid, day, or evening zones. Elevated Morning cortisol ight present as early morning awakening, waking up feeling stressed out.
High AM Cortisol

Elevated Mid-Day cortisol would look like the graph below. This might be caused by a high stress job or commute, skipping lunch, and other stressors that present mid day.
Might Mid-Day COrtisolElevated Evening cortisol might present as difficulty FALLING asleep with a racing mind or waking up soon after falling asleep. This pattern might appear like the one below.
High PM cortisol

A chronically stressed person, might have a pattern like the one below.  This could be caused by persistant anxiety or panic, PTSD, living in an abusive situation. Chronic Cortisol levels may remain inappropriately elevated throughout the day due to persistent activation. People with this pattern are often “wired and tired”, and are well on their way to stage III.
Cortisol High all dayWith chronic or severe stress, the capacity of the adrenal glands to cope is eventually exceeded and they begin to struggle to meet demands for cortisol and DHEA production. In stage 2, cortisol levels are often elevated but DHEA and Pregnenolone levels start to decline and this imbalance causes the symptoms that begin to emerge at this stage. Individuals in stage II will still be able to carry out their normal routine but they likely to experience increasing levels of highs and lows, and have more fatigue at the end of the day requiring more rest and sleep to recover. Unfortunately, with higher cortisol levels sleep itself becomes less refreshing, so the person often wakes up tired–a key warning sign of adrenal fatigue.

Many people in stage 2 also experience some degree of hypoglycemia following meals. Other symptoms that may also appear include: anxiety, irritability, and insomnia. Coffee and other stimulants begin to become very attractive to people in stage 2, and the majority of working adults in the modern world are probably in stage 2.

Stage 3: Adrenal Fatigue or Adrenal Insufficiency
If the sources of stress are not reduced, adrenal function will decline. At this stage, the adrenal glands are unable to keep up with the body’s constant demands for cortisol, and this too now begins to decline: both DHEA and cortisol may now be low on diagnostic tests. The decline in cortisol production is usually gradual, but steps must be taken to avoid progression to stage 4.

At stage 3 the body slows down, or begins to limit, some non-essential functions. It’s common to see patients with digestive issues and low libido. Stage III patients often experience increasingly severe aches and pains, muscle weakness, easy infections, slow to heal injuries, loss of exercise tolerance, distinct brain fog, insomnia and depression. In the adrenal exhaustion stage, people will almost certainly be struggling with daily living. Many if not most fibromyalgia and chronic fatigue patients have distinct adrenal exhaustion. Here are what these depressed cortisol patterns might look like:

Low Cortisol, Flattening of the DP

Low and Flattened COrtisolLow AM, remainder WNL COrtisol

Adrenal exhaustion patients are commonly self-medicate with heavy caffeine use–which only steepens the downfall of the adrenal glands. Standard allopathic medical care for the complaints of those in adrenal exhaustion usually involves: prescription stimulants, anti-anxiety medications, sleep drugs and powerful antidepressants. Of course, it is easy to see that all these measures are merely masking symptoms, missing the cause, and ultimately only making matters worse.

Stage 4: Adrenal Failure
Eventually, the tiny adrenal glands can become exhausted and stop functioning. This would produce a classic “flat” adrenal curve seen blow.
Very Low, Flat Cortisol, FAILURE

It usually takes many, many years and an extremely driven person to reach the  failure stage. At this stage, the patient’s condition is akin to adrenal insufficiency (Addison’s disease). In adrenal failure, hormone output is so low that there is a high risk that even essential metabolic processes cannot be maintained. Most people never get this far because advanced adrenal exhaustion will take someone out of the modern rat race before full-on failure can develop.

The recent advent of high-carb/low-nutrient food, highly stimulating prescription drugs (Prozac, Effexor, Adderall, etc.), anti-anxiety and sleep medications and supercharged caffeinated beverages combined with especially stressful lives have sadly unfortunately made adrenal exhaustion and failure more accessible and more likely in everyone.

What You Can Do
If you feel that you are experiencing the symptoms of adrenal fatigue, consider getting your adrenal hormone levels tested. A standard profile is about $150. Where-ever you fall on the scale of adrenal fatigue, in today’s world it pays to take care of your adrenal glands with adequate sleep, relaxation, exercise and nutrition. In my experience, many people further along the adrenal fatigue spectrum would also benefit from prescription herbs and targeted, high-dose nutrients (“nutriceuticals”).

The “Cortisol Steal” Phenominoncortisol steal2
The adrenal glands make three kinds of hormones: mineralcorticoids, glucocorticoids, and sex hormones. The mother of all of the hormones is Pregnenolone which is made directly from cholesterol. Cholesterol has a bad reputation for causing cardiovascular disease, but we now appreciate its escential role as a hormone precursor. What happens in Stage 2 and 3 is that the hormonal precursors get diverted to making cortisol and the other important hormones like aldosterone (important for keeping sodium and blood pressure levels even) and DHEA (which is the upstream precursor other sex hormones like testosterone, estrogen, and progresterone) get stolen to make the cortisol. The body is smart though and instructs the liver to make more cholesterol from the sugars starches and fats we eat. It’s very common for stressed people to have high cholesterol for this reason.

Where DHEA and Pregnenolone Fit in:


  • Orr TE, Taylor MF, Bhattacharyya AK, Collins DC, Mann DR.Stress of acute immobilization in ratsà inhibition of 17α-hydroxylase and 17,20 lyase. Orr Te, et al. Acute immobilization stress disrupts testicular steroidogenesis in adult male rats by inhibiting the activities of 17 alpha-hydroxylase and 17,20-lyase without affecting the binding of LH/hCG receptors. J Androl. 1994 Jul-Aug;15(4):302-8.
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The Thyroid Connection
The body will try to bring stage 2, 3, and 4 people back into ballance. One of the ways to do this is to slow down thyroid function. Thyroid hormone action sets the basic metabolic rate for every cell in your body from bones to brain cells and all the cells in your immune system. So the body is essentially using the thyroid as “the brakes” to slow these stressed people down by making them feel tired, weak, cold and slow. Any sane animal would lie down and take a good break feeling like this. Modern humanity–not so much.

The common thyroid screening test is thyroid stimulating hormone (TSH), and unfortunately it is of no value in looking for this thyroid connection. TSH comes from the pituitary gland and higher levels indicate that the pituitary master is yelling at the thyroid slave to make more thyroid hormone.

The normal ranges for TSH ought to have been updated by the labs and hospitals 15 years ago. Most labs still say a TSH is “normal” if the number is between 0.5 and 5.0. This is basically abominable. The American College of Endocrinologists recommended that the upper end of the normal range ought to be dropped to 3.0. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter. NACB indicated that anyone with a TSH of 2.5 or higher was actually likely to be hypothyroid. For decades patients with a TSH in the range of 2.5 top 5.0 have been told over and over that there is nothing wrong with them and that maybe they are just depressed or that it is otherwise all in their head.

In the exhaustion stage, thyroid function and (T4-T3 conversion) may also start to decline. It is imperative that these patients be checked for their TT3:RT3 ratio which is often way off despite normal TSH, normal T4 and even normal T3 tests. When FT3 levels drop or if TT3:RT3 ratio falls below 6, patients usually experience markedly slowed metabolism, weight gain, lower body temperature, constipation, reduced resistance to cold, depression, and extra irritability and brain fog.

stress&RT3What’s the right test to order to asses your thyroid function? I actually use four: TSH, FT4, FT3, RT3. Most modern MD’s actually have never ordered or heard of the fourth one: RT3. RT3 stands for “reverse T3” and it is made along with T3 from the precursor T4. When the body is under prolonged stress and cortisol levels get high for a while, the body makes more RT3 to slow you down and give you all the classic hypothyroid symptoms: cold, tired, achey, frequent infections, constipation, dry skin, hair loss. What happens when you give someone with elevated RT3 the standard thyroid prescription (Levothyroxine, Synthroid, T4)? They end up making more RT3 and gum up the works further. Poorly educated MDs usually throw up their hands at this point and will often try to give you an antidepressant. What these patients really need is more straight T3 (cytomel, liothyronine) or a blend of T3 and T4 from prescription Armour thyroid or Naturoid.

Fixing up the thyroid levels will make these fatigued patients feel better, for a while, but let’s not forget who started the crash. The adrenals and prolonged elevated cortisol levels. This needs attention too, or else the additional thyroid support will just burn out the adrenals faster. Giving piles of thyroid hormone to an adrenal fatigue patient is like covering the check engine light with tape when there really was something wrong. Given alone it’s may not be much better for you than drinking coffee to feel better. Solution: treat both the adrenals and thyroid together and also figure out and address what the patient’s major stressors were in the first place (chronic infection, chronic pain, mold or toxic exposures, anxiety, psychological trauma, etc.)

I hope that reading all this was not stressful! If you have made it this far and would like to get your adrenal or thyroid hormone levels tested, I am available for private consultations and will listen to you and work with you to get you the help you need.

trmorrisnd headshotDr. T.R. Morris is a licensed naturopathic medical doctor (ND). He is currently serving as faculty and consultant to the Institute for Functional Medicine (IFM). The IFM mission is to revolutionize medicine by teaching the latest genetic, nutritional, hormonal and other biochemically-based integrative medicine techniques to MDs and other practitioners looking for new tools to prevent and treat chronic disease. In the past, T.R. served as the medical director of a large integrative clinic and taught (genetics, physiology, biochemistry, microbiology, cellular & molecular biology) for 10 years for various medical programs in the Puget Sound. He sees patients in person (or long-distance via Skype consultations) from his home office in Seattle.
Contact Dr. Morris

Author: trmorrisnd

Naturopathic Medical Doctor and IFMCP (Institute for Functional Medicine Certified Practitioner) serving patients in Seattle, WA and wordwide through remote consultations

67 thoughts on “Adrenal Fatigue & Adrenal Insufficiency”

  1. Dr. Morris,
    I believe I may have Adrenal Fatigue. I have had Major Life Stressors and recently, during a minor stressor, my body couldn’t cope. I felt like I was going to pass out. I took my blood Pressure and it was 62/43 with a 50 pulse. I thought I was going to die. Instead, I vomited my dinner. I was so pale afterward. I live in a small town in Southern Oregon. It’s a great place to live. With all the stressors (taking care of disabled, sick, and addicted family members, foreclosures, and bankruptcies, etc.) , I am EXHAUSTED! I feel like I could break at any moment! I am taking presently: 10mg DHEA, AM/PM Rebalance by Balance Docs Inc.(an improved Seriphos Formula), 9 Biest & 6 Testostrone Drops, (Bioidenticals).

    1. That is an impressive list of stressors, Mona. The best way to improve your health would involve reducing your stressors, if possible. Then, for your own peace of mind, make a practice of compassionately training your focus on things that you have the power to do something about. For the things you can not change, practice letting go, and decrease your perception and focus on the remaining stressors. Though times may seem hard, remember to practice the attitude of gratitude, daily.

      You also need time to yourself, time to recharge. Clear space for some worry-free time, every day. Put it on your schedule if it helps. Even a few minutes a day would be an important a start. Mindful breathing can make a big difference. It’s as simple as counting to 5 or 6 on an in-breath, holding the breath for a few seconds, and then breathing out for a count of 5 or 6. MyCalmBeat is a free smartphone based “breathing trainer”, and there are sure to be others in the internet. However you do it, five minutes 1-3x/day can be very calming, and helps you remember to breath through stress throughout the day.

      Sleep, whole fresh foods, fresh air, clean water, and exercise, are your friends. Make room for and visit with all of these friends every day. Remember to find a place of gratitude for each of them. They will build you back up. Avoid or at least limit drugs, alcohol, and stimulants like coffee and tobacco if you can. Major habits can take time to fix, so be gentle with yourself as you progress away from them.

      If you have not had one already, I would consider an adrenal stress index (ASI with 4 salivary samples). DHEA-S, pregnenolone, and AM cortisol would be other tests to consider way to go with conventional laboratories.

      1. Thank you Dr. Morris,

        I was surprised to get such a quick responce. I am seeing Dr. Steven Rotter, an Accupuncturist, MD, on Wednesdy. I will bring your info to him about the cortisol tests. He had already suggested the Adrenal saliva test. I know I am very low on crotisol, as well. Otherwise, Nisha Jackson wouldn’t have put me on 10mg of DHEA.
        Quite an impressive Stressor list, heh? Yes, Indeed!

        Bless and Thank you, Dr. Morris,

  2. Timing of adrenal fatigue symptoms include:
    1) Profound morning fatigue and brain fog, most days. The most refreshing sleep comes in the late morning sleep hours (7-9AM), and people with adrenal fatigue may feel especially wrecked if this sleep is disturbed or does not happen.
    2) Adrenal fatigue patients are often heavy coffee drinkers and may not feel “normal” without 16-24 oz AM coffee, or more. They may still get a midmorning lull around 10AM and often feel better around lunchtime. Another mid afternoon lull in energy/mental clarity ~2-4PM is also common.
    3) By 6PM many adrenal fatigue patients may get a pickup in energy/clarity, but by 9PM may feel feeling tired/sleepy again. The driven (type A’s) will fight off the evening fatigue and get a second wind around 11.
    4) Adrenal fatigue patients often feel their best in the later evening (after their second wind), and may get busy taking care of home and work affairs get caught up in exciting TV, movies, or internet and eventually want to go to bed at 1-2 AM, or later.

    1. Oh wow this is my exact schedule!! I’ve definitely seen the effects in my life and home the last 18 mths. It all seem to start around the same time I began adderall for clinical diagnosis of ADHD and an s-assault that occurred. I have never been this forgetful, unorganized, messy, achy, in pain, etc in my life. Sleep rules my life. Thanks for posting this, I’d really love to know though what I can ask my doc to test for. They’ve tested thyroid 3 x and always say its in normal levels. So it makes me wonder

      1. Test AM cortisol and TSH >2.5-3.0 is not good enough. Ranges that go up to 5.0 are still the erroneous convention. FT4, FT3, RT3, TT3 are also quite useful. Most conventional docs will not run the last four thyroid tests, and even then, they tent to ignore “low normals.” a 4-sample salivary cortisol, DHEA-S and Pregnenolone levels can also be quite illuminating. You can contact me directly via email if you’d like a formal consultation on your case.

  3. Hello Doctor Morris,

    I was hoping for input from you. I am a 20, almost 21 year old with hormonal issues. I was diagnosed with Hypogonadism…then Hypothyroidism.. then Adrenal Exhaustion. I’ve felt bad for so long that I viewed it as my “norm” up until last year. I have ruled out a pituitary tumor for hypogonadism and now I am struggling to find out “Which came first? The chicken or the egg. I know that this is a very difficult question with such limited knowledge of my wellbeing. I am simply asking: Is it possible for Adrenal Fatigue to cause mild Hypothyroidism (TSH approx. 4) and Hypogonadism (Testosterone approx. 300)? I have failed to find information supporting this.

    Thank you,

  4. I am being treated right now with Synthroid and Androgel 1.62%. The reason why I ask if Adrenal Fatigue can cause these is a lifetime of TRT at such a young age feels very… strange to me… daunting as well. I only want to be on it if I have to. I am searching for an underlying diagnosis for my hormonal problems, but I keep coming up short.

    1. Hi Nate. Thanks for writing.

      It’s good that you had a pituitary tumor ruled out. With any serious hormonal dysfunction across one or several hormone systems you’ve got to do this. Outside of pituitary issues, people tend to break down in the following order: Adrenal fatigue –> Thyroid dysfunction –> Gonadal hormone dysfunction. Adrenal fatigue is still poorly recognized and most doctors rarely test for it (unless someone has full on adrenal failure/Addison’s-disease).

      Thyroid disorders are likewise pretty badly managed by conventional medicine: the testing is often limited to TSH and on a reference range that misses many, many sick people. A TSH of anything over 2.5 is highly suspicious in my book, and I like to see it around 1.0. Sadly many labs STILL don’t tag A TSH as abnormal unless it’s over 4.5, or 5.0. Another twist to thyroid testing is that hardly any docs test for RT3. Here’s the issue: if you overdrive your adrenals, your body will divert the precursor hormone T4 to the hormonal blocker RT3 instead of the primary active thyroid hormone T3. RT3 competes with the dwindling amount of T3, people feel really tired and foggy, and this usually does not have a big effect on TSH–so the conventional docs end up mostly throwing up their hands and saying “there’s nothing wrong with you” and may put people on antidepressants without looking further. This is abysmal! Check out the website for more revelations about thyroid hormone.

      If you keep driving yourself into the dirt after your adrenals and thyroid are really beaten up, that’s when the gonadal hormones (Testosterone for men; Estrogen & Progesterone for women) can start to tank. With hypogonadism, people can loose muscle mass, bone density, libido, mental clarity, self esteem can really go south, and some women also loose their periods completely.

      Back to you. Most people who march down the Adrenal–>Thyroid–>Gonadal dysfunction highway have some kind of chronic stressor going on: food allergy, gluten sensitivity, toxic exposure/accumulation, mold in the home, some infection, an untended injury, chronic pain, anxiety, mental/emotional stress, situational stress, etc. Identifying and treating or reducing your stressors can only help your health and may well be *critical* to your overall recovery and the path to getting off hormone replacement therapies.

      Make sure you are being treated by a well trained doctor: a board certified ND from an accredited 4-year program, or a IFM trained “Functional Medicine” MD/DO. Get your AM cortisol tested, or better yet a good 4 sample salivary cortisol assay. Also look at DHEA-S (cortisol and sex hormone precursor), and get an expanded thyroid panel (including FT4, FT3 and RT3). If FT3 is low or lowish or if RT3 is even in the upper third of normal, you need T3/Cytomel, NOT T4/Synthroid. Synthroid can normalize your TSH and still get diverted to RT3 or fail to get converted to T3. It might be worth getting your secretory IgA measured and getting tested for gluten sensitivity (IgA and IgG antibodies to deaminated-gliadin, TTG, Endomysial tissue) or just taking 6-8 weeks off gluten (wheat/barley/rye products) completely.

  5. My first diagnosis was hypothyroidism, then graves disease, then pituitary tumor. I have been on numerous antidepressant. I have weened myself off all medicines. I truly believe what i have is adrenal fatigue. Can this run in families. My son has recently been diagnosis with celiac disease and osteoporosis. Which was all found after a back brake. I think it is possible he has some adrenal problems also. Do you have any suggestions for us. I feel like most doctors just doctor the symptoms and don’t look for the underlying problem. Please help!

    1. Hi Ginger. First please tell me if those first three diagnoses have all been ruled out now? A pituitary tumor (usually diagnosed by an MRI of the brain) can be life threatening and is therefore not something one should dismiss. We don’t generally think of adrenal fatigue running in families, but it can. For instance: genetic vulnerability and common stressors within a home or family environment (chemical toxins, mold, cigarette smoke, noise, substance abuse, difficult relationships, poor diet, food allergies, family illness, common lifestyle pitfalls, etc.) can all contribute to people developing adrenal fatigue. Your son’s osteoporosis is probably related to celiac–and it is a good thing it was caught. Celiac and gluten sensitivity is often connected to thyroid issues. I’d join him on going completely wheat and gluten free for 2-3 months, and see how you feel. You may also want to get your AM cortisol checked, or a 4 sample salivary cortisol/DHEA. Other lab tests to consider would be a RT3, and your own celiac/gluten sensitivity testing.

  6. Hey Dr. Morris,

    I am a second year medical student, so my stress levels are always high and peak with test blocks. I was diagnosed with Graves’ disease last February and then had RAI done in June. By September I had gone hypothyroid and was prescribed synthroid which has been increased about every 6 weeks trying to regulate my thyroid and find the correct dose. The last month and a half fatigue and muscle weakness has progressed. Waking up at 5:30 is normal for me and I was having trouble waking up by 7 many days. I just never feel fully rested. I really can’t afford to get more than 8 hours of sleep with how much I have to study. Two weeks ago we added cytomel 5mg to my regimen and decreased my synthroid by about 20mg to 112mg to try to finally get my TSH to normal levels as that is the only thing my endo is willing to check ( My TSH about a month ago was 5.47). I had to convince her to add the Cytomel. This was on a tuesday and each day I got worse and worse and by Saturday and Sunday I could barely get off of the couch. I would just start crying for no reason at all. Every muscle in my body hurt and all I wanted to do was sleep. Desperately to try to stay awake and study I tried Coffee and Red Bulls which would do nothing it seemed and sometimes even seemed to make me more sleepy. I noticed my best studying time was in the evening when normally that is my worst. By Monday morning as I was sitting in class, my heart was racing around 150bpm, I could not focus on anything and was having major anxiety. I knew something was really off at this point so I went to the ER room. My bp was 150/107 and and HR was then 132bpm and fluctuating constantly from 100-130. They immediately did an EKG and admitted me and ran blood work. My sodium and potassium levels were in the normal range (at this point I was suspecting Addisons disease). They claimed I was dehydrated and after a bag of fluids everything dropped to more normal values (125/79 and 105 ). My TSH for the first time ever was 0.737 and in a normal range and FT4 was 1.6. I still don’t have the results for FT3. So my question to you is do you think adrenal fatigue helped cause the dehydration (I drink lots of water each day)? I can not get in with a new endo for another month to have my cortisol levels checked. In the mean time is there anything I can do to help my energy? I have felt much better after a couple days of recovery from the ER visit but still not great. Is there a chance this will happen again before I can get in with the endo? Sorry for the novel. Thanks in advance for your help.

    1. There is a correlation between graves disease and gluten sensitivity. There are many IgG and IgA gluten sensitivity tests, and you could run these. If I were you, I would try going completely gluten free for 2-3 months starting now. Step down off the caffeine too while you are at it. Drink two emergen-c Packets a day and take extra b5 for your adrenals. What is your lifestyle like? Are you taking time out for regular moderate exercise (i.e. 30 minutes of 60-70% heart rate max 5x a week)? Are you taking time to relax and not think about school? There’s a good chance that you will feel a lot better with just these interventions.

      Did the RAI completely wipe out your existing thyroid hormone production? Or did it leave some behind? Make sure that your new endo is willing to work with you. A good naturopathic doctor (ND) or functional medicine doc might be a better option for you than any run of the mill MD endocrinologist.

      It’s hard to say much for sure on your dosing until we have your RT3 and other lab results. Adding the T3 was a good thought. It may be that you need even less T4 and a second dose of T3 in the early afternoon (T3 has a *much* shorter half-life). Another option is to take Armour or Nature-Throid. 2 grains doses have 76 mcg T4, 18 mcg T3. It takes time to find your sweet spot. A high normal RT3 has me tipping the scales toward more T3 and less T4. You will have to titrate the thyroid based on how you feel in addition to the lab values. A TSH of 0.5-1.5 is usually where I aim, with ~1 being ideal, but how the patient feels is paramount.

  7. I am late stage 3, went into a cortisol crisis about 7 months ago. I know it is from stress 7 years ago a surgery, continued horrible events in my life did not let go from that time on and 1 and 1/2 years ago I lost my dad and that broke me as I was already down and couldn’t deal with it at all….. after 6 years and some months trying to figure out what was going on and doctors just wanting to put me on anti-depressants, I finally ran into someone who had gone through it really hard. My digestion had shut down was having heart trouble, had no muscle left, no strength, some days could not lift my arms or legs or even get out of bed and doctors still didn’t know what was going on, I do have hypo thyroid as well and am confused as to whether I should treat my thyroid, I am told if I treat my thyroid it will put stress on my already almost dead adrenals, and then told I should treat them to take stress off my adrenals, I am confused there. I went into cortisol crisis when I got the test and doctors put me on steroids….. it is like an ocean of coffee, and pushed my adrenals so hard they almost gave up and that is when I went into a cortisol crisis, I saw a naturopath at that point because I didn’t trust the regular doctors after that, and have been being treated by a naturopathic doctor since, it has been 7 months or so…… I am super weak, still have days I can not get out of bed, sometimes just walking up the stairs wears me out, I have 4 kids and can hardly be a mom or do what I need to around the home, I never enjoy sex and can not have an orgasm (this is very depressing), really I am not someone I even know nor enjoy, it is like living with a stranger in my body, my life is depressing, and my family has to do without me and suffer as well….. I am on DHEA and Pregnalone, I take Phosphorus, take Eluthro Rhemannai during the day to help me stay up and the phosphorus in the evening to bring me down, trying to keep adrenals on a good schedule….. I eat lots of raw food, smoothies, lots of protein, gluten free, no refined sugar, no dairy, try to exercise daily (this consists of small walks since I can not run or do aerobics) etc…. I have hardly made progress, just managing to keep myself alive is all. I don’t know what else to do, but am very tired of living like this, anything else I can do??? I have done full body cleanses also and try to be positive but is really hard to be at this point. Any advice is appreciated. I am told it will take 2 – 3 years for me to heal as hard as I have gotten down, but it has been 7 months and I feel like I have made next to no progress, not sure how I will get well at all like this.

    1. Hi Christine. saga you have there. It’s true that just treating the thyroid can stress the adrenals out further. That said, dragging yourself through days without adequate thyroid function/support is also a big stress. A good naturopathic or functional doctor will do a thorough workup that involves FT3, FT4, RT3 (not just TSH) and study exactly where you are in the ranges of normal/abnormal. There may be other underlying things going on for you that are stressing your adrenals: Sleep disorders, GI dysbiosis, food allergy/sensitivity, autoimmune issues, chronic infection (viral/bacterial/fungal paracitic), chemical exposures, mold exposures, etc. If there is something along these lines going on, then it is critical to your health to identify it and treat it. I’ll send you an email so that we can work together on your case.

  8. Hi Dr. T,
    I recently had a blood test W/ Cortisol levels being @ 20. The urine/blood test revealed that my cortisol is high in the mornings upon waking, lessen during the afternoon & are very high in the evenings. I feel Exactly the way Christine feels. I have had chronic sleeplessness. Aside from having severe backaches (which I believe resulted from an injury years ago), and when I lay down to sleep, I have post nasal problems. Which, also, cause me to awaken, tossing & turning to breath. I went back my NP who lowered my Thyroid medication from 90mg to 60mg. I’m beginning to have blood pressure problems, the other evening 88/46. I quickly propped my feet up. A few months ago I started taking Hydrocortisone 5mg to help me thought out my day. I was given 10mg Valium to take when I’m stressed. ( I cut it in half & only take half when needed). I, also, was provided Ambien to help me to sleep. I am aware of the side affects & only take one every other night. I try Not to take these at all, only when I can sense in my body that I’m high strung from my stressors. I am Thankful I was provided Something to help me sleep.
    My husband was finally 100% disabled through SSDI June of last year. He was diagnosed with Poly Peripheral Neuropathy, a severe form Fibromyalgia & a personality disorder, which I suspect Narcissism. He was awarded 70% PTSD through the VA this past December. They say the wives suffer more severe PTSD from being married to a Vietnam Veteran. You already know the other stressors I’ve been through. Any more Helpful thoughts on your end? I texted my Acupuncture Dr. & asked him if he would consider the FT3, FT4, & RT3 to see if my ranges are normal/abnormal. he3 said he would. 🙂

    Thank you Dr. T,

    1. Hi Mona. That’s a potentially very serious BP issue you’ve got going. I would personally not leave my care with an accupuncturist. We docs have to think about worst-case scenarios first, but you may well need to be admitted to a hospital. In any event, you need to rule out serious conditions: GI bleed, Sepsis, Addisons disease, heart failure, etc. That said, I’d want to see a metabolic/chemistry panel that has fasting blood sugar, albumen, sodium/chloride/potassium and the other goodies. Also get a DHEA-S.

      Be aware that it takes a sensitive eye to read the labs correctly. Hypothyroid can cause low blood pressure too. The standard “normal” ranges for thyroid miss many people that actually have problems. That said, some folks in the alternative realm may read too much into labs and try to rope you into some schtick. A TSH above 2.5 is likely to be abnormal–though the labs tell you that anything up to 4.5 or 5.0 is “normal”. This is bewildering because event the American College of Endocrinologists (a conservative group) recommended that the top end of normal TSH be dropped to 2.5–OVER TEN YEARS AGO. My point is that you need to look at where you are within the lab’s arbitrary “normal” range for many of these tests.

      Back when I was in medical school draining my adrenals and zapping my own thyroid, I posted a TSH of 4.98, and my internal medicine MD told me “you’re fine, nothing to do here”. At the time, I believed him and figured that I was being lazy or something. I was almost double what ACE calls normal and 0.02 away from what the old stick in the mud MD’s call “normal”. I had serious issues going on that were missed and ignored. RT3 is one where even if you are in the upper third of “normal”, I like to add more T3 to the patient’s thyroid Rx (because the adrenals/cortisol are misdirecting the T4 into inactive RT3 instead of active T3).

  9. Hi Dr. Morris,
    I have had “adrenal fatigue” for over 3 years. It wasn’t unitl this year a Dr. actually checked my RT3’s to find they are high. This Dr. started me on 30 mg of cortisol and a “compound T3 of 37.5 twice daily.
    The cortisol finally seems to be tolerable however, I am adding 5 mcg T3 every three days.
    While only on 10-15 mcg’s I still feel no relief and it’s been a few months.
    My DHEA came back “normal” as my other hormones did.
    Low Vit D and low L-methlfolate so I’ve been diligently taking these also omega 3 for inflammation.
    My Cholesteral has been high since I was 18. I am now 45. I didn’t address it with “statins” and was certain it was genetic because my diet was too clean @ 18 anyhow.
    I am not “celiac” but I stay away from wheat anyway.
    I’m just very concerned because I am having NO relief. I am not motivated to do ANYTHING and to say the least after 3 years..I’ve resorted to disability and severe isolation. because just to bathe is too exhausting.
    Do you have any advice?
    Thanks so much for your consideration and your Web site!

    1. Hi Michelle. Thank you for reaching out. From what I can gather form your post there is a lot going on here–including some things that I am concerned about regarding your aggressive hormone treatments that don’t seem to be working. Unfortunately, I can not help you much over an informal forum post. It would not serve either of us to have me fire off some half baked advice recommendations from your writeup. I can tell you this: I’m not surprised that you are not getting relief and that you are slipping further into fatigue.

      The body uses RT3 as “the brake” in order to slow us down when we’ve been running ourselves ragged. It feel like crap, but if we take massive doses of T3 it’s like whipping a lame horse to go faster or putting tape over your check engine light. I think 37.5mg of T3 twice a day is way too high already, and that it’s downright dangerous to be adding 5mcg more every three days. Likewise with cortisol. Again, I can’t tell from your writeup what’s going on. If your “other hormones” that came back normal included cortisol, then I can’t understand why you are taking 30mg once or twice daily (one can’t tell which you meant there). If your cortisol was low before you started taking it, then any lasting solution for you has to include identifying and attending to the cause of what stressed your adrenals out in the first place. If that process is ongoing, then the whopper doses of T3 and cortisol are only going to burn you out further. Although it’s becoming more common, I think it is irresponsible to haphazardly stoke someone’s fires with giddeeup hormones like RT3 and cortisol, while leaving something else that’s very wrong.

      In order for me to help you, I’d need to have your complete medical history and the history of your present illness, including specifics about your symptoms, all your labwork, prior treatments & responses, current drug and supplement regimen, environmental and employment data, diet, sleep, and activity logs, etc. This is all part of my 10 page intake form. Filling that out is the fist step in getting ready for a real consultation with me. That way, you’ll get the right recommendations that are personalized to attend to your needs and situation–and I get to make a living helping people. I’ll email you my intake form, and you can find my rates on the services tab of my webiste.

  10. Hi Dr Morris, I believe I have an adrenal problem and have been seeing an endocrinologist at Virginia Mason in Seattle but she does not specialize in adrenal disease. I have had labs showing a low morning cortisol of 4.0, low testosterone, low DHEA, and an ACTH stimulation test that according to the lab was abnormal but she said my adrenals are fine after these tests. My T3 was actually elevated (both free and total). I don’t think she is even running the right tests. I have a complex medical history including a pacemaker and a mixed connective tissue disorder for which I take weekly methotrexate injections for. Two years ago while being diagnosed I was on a huge dose of steroids (up to 1000mg Solumedrol IV drips) and I think this has played a huge factor and created an adrenal problem. I am a 31 year old female, and am an RN. I have been off work on FMLA leave from work since October 13th and am not getting any answers. I see you practice in Seattle, how would I go about making an appointment with you? Do you take insurance? I would love to get your opinion, I am so sick and am now desperate. Thanks!

    1. Hi Annie. Thank you for reaching out. Conventional endocrinologists are trained to be very narrow-minded in their interpretation of lab results. Many patients bounce out of endocrinology workups just like you did: with no diagnosis and no help. Extremely frustrating and disheartening, I’m sure. My professional training enables me to take a much wider view on your case. I will more carefully consider your labs, symptoms, and complete health history. My intake form is no joke: 12 pages long, and it elicits great detail about your chief concerns, personal and family medical history, diet and lifestyle, current and past medications, past labwork, and has a rigorous review of systems/symptoms page. Filling it out carefully is a good exercise for you, and enable us to hit the ground running in our first appointment.

      I don’t bill insurance anymore. It was twice as much work for less than half the pay and tied my hands to do alternative treatments. Many of my patients get some degree of coverage through “out of network benefits”. You can call your insurance company and ask about this. The visit fees are found on the services tab of my website. I’m looking forward to helping you, and will email my intake form now.

  11. Hi Dr. Morris,

    So happy to have stumbled upon this article. It’s amazing how much more there is to learn once you understand what some of the underlying issues are.

    My history (I’ll try to be brief) is as follows:

    – Had horrible (isn’t it all) colic as an infant (sorry mom!)
    – Was constantly sick with colds and gastro issues
    – Had countless allergies and started to receive allergy shots 3 times a week as young as 4 years of age until I was about 6 and we could manage (grew up in cotton and peanut land in Alabama so that was no small task)
    – Was diagnosed with IBS, spastic colon and lactose intolerant at Children’s in Birmingham at the age of 12

    – was finally (after having known for probably 10 years) diagnosed with ADD by a specialist (who didn’t know how I had gotten through high school much less college with good grades). ADD majorly runs in my family – all 6 first cousins have it to varying degrees, mine being on the lower scale (holidays are interesting, ha)
    – started taking adderal at 25 because I was in a high stress job that required unparalleled levels of organization and I knew that I had to be on something (after years of trying to manage with CBT) in order to keep my job.
    – had mono in 2009 for 6 months at the age of 27. Up to this point had been the picture of health in terms of eating right and exercising. Luckily I still appear to be in shape and thin, ha. I also cut out gluten during this time and haven’t eaten it to date.
    – 2010 – 2013 my primary care doctor blew off my complaints and said it was because I needed to exercise (which I didn’t have the energy to do) and once I started back to yoga / pilates lightly in 2013 – I couldn’t keep it up because I’m constantly sick with a cold since I have a horrible immune system.
    – Sept 2013 – Now:
    I am seeing a CFS specialist who is an Allergist / Immunologist in NYC. Ever since I had the terrible case of mono in 2009 I have struggled for the past 4 years with major fatigue, insomnia / depression / anxiety (which I had had before the mono but symptoms were worse), serious brain fog / cognitive issues as well as a horrible immune system (which as never great to start with but is worse now). I have been on adderal for the last 6 years for ADD but ever since I had mono years ago it’s really served as more of a stimulant to get me through the day than a treatment for my ADD (which is pretty bad). I have the typical sleep patterns that you describe in this article (had to show them to my husband who thinks I’m nuts when I talk to him about sleep).

    I was just diagnosed with CFS in September of this year as well as chronic EBV and hypothyroidism. The levels in my blood work that were off were the following:

    Sex Hormone Binding Glob – HIGH – 203.0 (this could be because I am on Yaz)
    Vit C – LOW – 0.0
    IgG subclass 1 – LOW – 396
    IgG subclass 3 – LOW – 35
    EBV Ab VCA IgG – HIGH – >8.0
    EBV Nuclear Antigen Ab, IgG – HIGH – 4.0
    Chlamydia pneumoniae IgG – HIGH – 1.6
    HHV 6 IgG Antibodies – HIGH – 7.84
    Vitamin B6 Plasma – HIGH – 42.4

    Since then I have begun Armour 60mg once daily in the morning. I’ve been doing this for 2 months and my thyroid levels haven’t changed enough. 2 weeks ago I had my cortisol levels tested and was told that they are twice the normal level and that my WBC count was very low.

    I am desperate to get my energy and immune system back. I’m now 31, have just started a new job but am working from home so my work environment will be far less stressful than it had been for the last 5 years (the last of which I was completely miserable and beyond stressed). I’m gluten free, I’m trying to stay away from alcohol as much as a 31 year old can and try to eat a low sugar / low carb diet. I’m attempting to get into meditation and breathing but have to admit that it’s been very difficult for me as my mind is always wired despite being foggy and tired.

    Lastly if you know of a doctor of two in NYC that you think would be worth seeing please let me know a couple of names if you have them. I’m ready to end this!

    Thank you for your time and sorry for the novel,


    1. Hi Courtney. It does sound like you are being held together with ADD drugs and thyroid medication while the underlying causes: chronic stress, chronic Adderall (ab)use, chronic cortisol issues, depressed immune function. There may well be GI dysbiosis, food sensitivities/allergies, environmental allergies, chemical sensitivities, and a sleep disorder (Adderall is good at causing this) also at work. To find a IFM certified practitioner, go to the IFM website and use the “find a practitioner” tool.

  12. I have a question that i hope you can help me with. I have had a prescription for adderall for the last two years. I am prescribed 40mg generic per day. Over the past two years i have had a lot of school and done well with the aid of adderall. For the first year i probably only took about 10mg a day if i averaged it out. i broke it into pieces for when i studied. Now about two years later i have gradually increased my usage to close to the 40mg on heavy study days and less if its light hw day ect.. (i dont take it every day but probably 5 days a week of varying doses) I do feel considerably more tired on days i dont take it at all.
    I graduate in a month and i dont want adderall to be a part of my life after school is over.

    So do you think i have damaged my adrenals over the last two years? Some impact has surely been made on them i would think. How would you recommend I discontinue adderall for the best results? Any supplements or advice would be greatly appreciated!

    Ps. I eat gluten free and relatively healthy already.

    Thank you.

  13. Dr. Morris,
    I found your website while researching adrenal fatigue. I am very proactive in my health and am constantly looking for answers (I have a BS in biology).
    Where to begin…I have suffered from chronic pain since I was a child. When I was 17 I was diagnosed with lupus. That began many years of medicine trial and error. I have been on so many meds I couldn’t even list them. While in college I slacked off and did not regularly visit any doctor. As the years went on I continued to get worse and went back to seeing a rheumatologist. I’m 33 by the way. About 4 years ago I had surgery to remove a osteoma tumor from my skull. Part of my skull was removed and replaced with titanium mesh. I was in the hospital for 5 days, 3 for recovery and 2 because my blood pressure was way too low and would not normalize. I never really recovered. My pain throughout my body was/is bad and the fatigue was/is horrible. From the time of my surgery on I was on narcotic pain medication. I went from Vicodin to Percocet to Nucynta and finally to the Fentanyl patch. I became addicted and somehow lost myself. They all worked so well on my pain and gave me the boost in energy I needed to get through my life. Then 2 years ago I lost my job, a job I loved dearly (I was a high school biology teacher). Three months later I discovered infidelity in my marriage and 2 weeks after that I discovered I was pregnant with our third child. We did not plan it, but we have always had to be very careful because I got pregnant extremely easily. I have been pregnant six times but miscarried 3 times. Only 2 of those were planned. I always had a feeling this was due to hormonal imbalances. I was diagnosed with moderate endometriosis when I was 14 and went through surgery to cauterize my uterus and damages tissues. My periods have always extremely heavy and painful. At two months into my pregnancy I became bed ridden. My pain was bad but I was so tired I couldn’t function and I could keep no food down. I was told I had Hyperemesis Gravidarum, aka extreme vomiting. I was bed ridden and sick the rest of my pregnancy. It was the worst experience of my life and I was so beyond tired that many times I couldn’t even talk. At 36 weeks I went into liver failure and had an emergency induction. My daughter was perfect and had no issues. Since then my energy has never returned. I pretty much stay in my bed as much as possible. I feel lost and hopeless that I will ever be able to work again. My older girls have a different mother than they once did. 3 months ago I decided to go off all of my meds, including my pain meds. I went off cold turkey and had a couple weeks of pure hell. I then started a regime of supplements and changed my diet. Since giving birth I have lost a lot of weight and have very little appetite. My muscles are virtually gone. I have chronic back problems with a lot of pain and my muscles just won’t hold the bones in place. After I detoxed myself I found a new doctor specializing in pain and holistic healing. I was further diagnosed with fibromyalgia. My new doctor (whom I love) convinced me to go back on some meds and one was a low dose narcotic pain medicine, but was extended release. So currently I am on 100 mg Nucynta ER 2x daily, Lyrica 225 mg 2x daily, and tizadine for muscle spasms in my back. I still have bad pain days, but overall I feel better. But the fatigue is still awful and I have zero motivation to do anything. I’m just at such a loss.
    After research I think adrenal fatigue is very possible. I would love to hear your thoughts and suggestions as I don’t even know where to start. I want my life back and to be a real mother again and be able to do things. I would do almost anything to get the rid of the constant demon that drags me down.

    Thank you,

    1. That’s an impressive story, Kristin. Thank you for being so detailed. First off, I think you should get the 23andme testing done, run the raw data through the detox and methylation filters and then work with a knowledgeable licensed ND or IFM certified functional medicine practitioner that knows their way around genetic profiles. Your hx of 3/6 miscarries suggests that you may have a serious MTHFR variation related to the way you methylate and process folic acid. It would also be interesting to see what a 4 sample salivary cortisol test showed (or at least an AM cortisol and DHEA-S from serum). Send me an email if you’d like my help remotely, but an in person consult would be best if that’s possible.

    1. Good question Eric. Stage II is marked by hyper-secretion of cortisol (too much). Cortisol is a “glucocorticoid” meaning that it increases mobilization of glucose (sugar) from glycogen stores. So when cortisol goes up, so does blood sugar. What happens next is that the pancreas reacts to the higher blood sugar with a spike in insulin–which quickly drives blood sugar too far down (AKA “reactive hyperglycemia).

    2. Stage II of adrenal fatigue is marked by increased secretion of cortisol–and often insulin. Together, theses two can work to cause an initial increase in blood sugar (from excess cortisol) and then a sharp fall (from excess insulin) in blood sugar “reactive hypoglycemia” to meals.

  14. I suffer from AF from a year. I’m very depressed, because from day to day I’m tired. Reason was the heavy workouts for 2 years. Since a year I try to regenerate, but nothing better. My symptoms: lack of energy, probably hipoglicaemia, low libido,muscles pains,”shooting in the joins”, low weight, It’s me could, steel sleepy, need for salt, I sleep even well). From 1 day of symptoms, I felt that something was wrong. I began at once to eat fatty acids, zinc, witamins, but nothing. I would like to ride a bike, work out, run, but I can’t.Now I know, that I made a mistakes of training. I don’t know how to help mysel. can you know? :///// Very thanks for ansfer

    1. Thank you for reaching out, Rob. It is not really possible to provide medical advice for complex chronic conditions like yours over the internet. You really need to have a proper assessment with an outstanding licensed ND, an IFM certified Functional Medicine practitioner, or another skilled and well-trained integrative provider.

      To really have a “functional” approach to your case, we would need to get a complete and detailed timeline of events in your life and medical history–including all your previous illness and injuries, details of your current symptoms, the history of your major stressors, potential toxic exposures, all supplements, hormones and drugs you are taking and have taken in the past, etc.

      That said, I think it might be valuable for you to have advanced thyroid testing, adrenal testing (cortisol/DHEA), and depending on your symptoms perhaps other hormone testing (testosterone, estrogens, pregnenolone, 17-OH pregnenolone). THAT said, it’s probably very expensive and not really valuable to “shoot in the dark” at possible causes without all the information required to make appropriate guesses at what may be the underlying cause of your fatigue and other symptoms.

      All that is to say, that my advice to you is to get yourself to a licensed ND or IFM certified practitioner (IFMCP). If you can not find one in your area, you can email me privately and I will send you my 14-page intake forms and (after I get them back completely filled out) we can begin formal remote consultations via phone, email, or Skype.

      1. Hey dr Morris

        I am a 26 year old active female. I recently went to a hormone dr because I was feeling super tired, not losing weight, gaining weight, foggy memory, foggy thinking and extreme mood swings and irritability. After a bunch of test he confirmed my adrenal glands were suffering fatigue. My progesterone and testosterone levels are extremely low, I have b and d vitamin deficiencies, and mild hypothyroidism. Currently he put me on liothyronine, natural estro dim, progesterone pills, omegas, a supplement to support my adrenals along with d and b vitamins. My question to u is is he doing this correctly? Should I even be on liothyronine? It’s been almost 2 months I feel no changes and have lost no weight.

      2. Without going through a complete intake and consultation process (and seeing your current and prior lab results), I can not comment on the appropriateness of the hormonal treatments meaningfully. It sounds like you have been given a wide spread of hormonal bandaids. This kind of hormonal treatments can help in the short term, and I would be concerned if they were not making a noticeable difference by 3 months. HOWEVER, the cure you are seeking will not probably not magically materialize though pills and hormones. You must also identify and address the underlying causes of the long-term stress such as: inactivity, poor diet, caffeine and other substance overuse, disturbed sleep, food allergies/sensitivities, indigestion, dysbiosis, chronic dental infections, toxic exposures, mental/emotional stress (bad jobs, excessive caretaking, toxic relationships, anxiety/depression, financial stress, predominant victim thinking), etc.

  15. Hi,
    I was wondering if you do Skype appointments or phone consults?? I really need help and it sounds like you have a lot of experience in this.
    Please let me know

  16. I am 47 with addisons caused by excess amounts of steroids due to my chronic fungal sinusitis. I take hydrocortisone and add to my required daily dose as needed when stressed etc. I cannot get past this feeling of mental fatique, weakness, just not motivated to do ANYTHING. I have a phyciatrist to help with my mood and depression caused by my condition. I asked him if he could prescribe me something for my fatique. He started with phentermine which just put me to sleap. I am now trying Adderall I started taking a weak ago, and I feel human again a feeling I haven’t had in years. Is this a temporary reaction and if I continue to take the adderall what are the long term effects with my addisons. Thank you so much for your time. TRISHA

    1. Using stimulants in chronic fatigue is a dangerous bandaid, at best. I think that over time it is highly likely that your body will adjust to the Adderall, symptoms will likely return, “requiring” increased doses that lead to increased tolerance… I don’t think that this path is the answer.

      Are your adrenals completely dead? (Did you have 0.0 response to ACTH challenge testing?) If not, I think a systematic and functional approach to your case could help. This would include things like: addressing the chronic sinusitis, other chronic infections (including GI dysbiosis), other stressors, digestion, nutrient deficiencies, food allergies, and sensitivities, supporting sleep, slowly increasing your exercise tolerance, building positive relationships, identifying purpose, retiring victim stories and similar costly reinforcements, and getting off any unnecessary medications.

      Your thyroid also ought to be thoroughly checked out. A TSH over 2.5-3.0 with symptoms of hypothyroidism (cold intolerance, all day fatigue, constipation, dry skin) can and should be treated as hypothyroidism. Most conventional docs still use the antiquated cutoff at 4.5-5.0–and will tell you that your thyroid is fine even if if you have a TSH of 4.99). So find out what yours is. In any event, it’s also important that you have your TT3:RT3 looked at. A ratio of anything less than 10 is suggestive of an over-conversion of T4 into RT3. Some integrative doctors use a TT3:RT3 ratio of anything less than 6 as suggestive of needing more T3. Most conventional docs are not looking at RT3 at all.

  17. Hi there I am a 26 yr old female who has been dealing with what I think is leaky gut and adrenal fatigue. My thyroid levels are fine. They were tested about a month ago. I have been functioning on adderall in the am and am sleeping with serequel at night due to the fact that I would go weeks on end with anxiety and severe insomnia. Prescriptions are not my ideal but due to the fact of working 2 jobs my options are limited. I supplement a lot and would eat organic approx 75% of the time. I don’t eat wheat and have occasional dairy such as grass fed butter or feta. Being the age that I am following leaky gut and adrenal protocal can be extremely isolating. Is it possible to taper off ptrscriptions over time. Generally the issue is sleep it just doesn’t happen I have taken every supplement/prescription out there. Depression has been another big issue, I feel like there is no fix. I am 5″6 and weigh 110 lbs. usually when I strictly follow protocol I lose even more weight. This happened with the candida diet. Here is a list of my supplements. Any advice would be greatly appreciated! I have a coffee and water in the morning then have an organic juice powder drink with collagen and vitamin d3 in the afternoon followed usually by a salad with grass fed beef or chicken and rice or quinoa. I know we’re not really suppose to eat these carbs but my body needs something. Occasionally I eat eggs but I was a little sensitive to them on my food allergy chart. I have cavities in my teeth and have been trying to remineralize them meaning no nuts etc. does neons have any advice or a new protocol to follow?

    Mid morning:
    Methyl folate Dedicated liver
    Krill oil. Fermented cod liver oil
    Pure vitamin club

    Spiraling chlorella
    Milk thistle
    Vitamin c

    Every couple days I have a methylcobalmin vitamin b injection.

    1. Anxiety and Adderall are not a good mix. I would expect that it sets you up for more severe anxiety. The Seroquel sets you up to need the Adderall in the morning–and vice versa. I would aim to slowly taper down on both–with medical advice/contact/supervision.

      Overdosing on methyl folate and methyl b12 is possible. Some patients report anxiety with them. I suggest you do a 1-month washout on both and see how you feel.

      Working on your GI is never a mistake. Think about probiotics 30-100B CFU per day and digestive enzymes if you think you may need them. Brown rice and quinoa are not bad for you. Your language about “I know we’re not really suppose to eat these carbs” sounds like too strict of a paleo perspective. I think you should eat them if you crave them. You’ll be able to keep weight on more easily when your digestion is better and once you are off the Adderall.

      A TSH of >2.5 is potentially indicative of low thyroid output. What was your score? Get TT3 & RT3 testing in a fresh round of thyroid tests along with an AM cortisol test (7-9AM) to get a baseline for adrenal output.

  18. Hello Dr. Morris,

    I have a genetic disorder called Ehlers-Danlos Syndrome and I have Relapsing-Remitting Multiple Sclerosis I have lesions all down my spine throughout my brain and on both optic nerves. I was also just diagnosed with Addison’s Disease and pernicious anemia. My DHEA-s level didn’t actually say what number just <15 and after the ACTH AM challenge my cortisol didn't go higher than 0.6. I'm now on B-12 injections hydrocortisone and so many other drugs. My TSH is 1.3 but the endocrinologist says that is normal. What do you think? I am a 33 year old woman. I don't know if age and gender make a difference in test values. My pituitary MRI was normal and my adrenal MRI had small <1cm nodules but were otherwise unremarkable. I just feel like I'm getting sicker and sicker and no one can help me as a whole person each doctor just treats the piece of my diagnosis that they know and understand but what could be causing all of these disorders? I had a colonoscopy and edoscopy to test for celiac which was negative. Do you have any thoughts or suggestions? Thank you for your time.

    1. If your endocrinologist is only replacing cortisol, you may want to carefully look into where you are within the normal or abnormal ranges for the other adrenal hormones. Breaking up the doses so that you have a little afternoon bump might be worth considering.

      It sounds like your ACTH challenge test was low (it’s hard for me to be sure without the units and normal range), so I wonder if your aldosterone, pregnenolone levels were looked at. LH, FSH, Estrogens Progesterone too.

      The thyroid test of just TSH is not the complete picture. Get a FT3, FT4 and a TT3:RT3 ratio (n =>10) done. Most endocrinologists think this is which-craft and wont go along with it easily. You may need to find a good ND or functional medicine doctor. If the Addison’s and pernicious anemia are autoimmune (likely), then you may want to consider thyroid Anti-TPO and Anti-TG testing too.

      In any event, make sure that your vitamin D3 and DHEA levels are optimal and that your diet and digestion are supporting good immune function. Supplement as needed. I’d go gluten and dairy free and and take probiotics–digestive enzymes/HCl if indicated too.

      I can’t say much more without a complete 90 minute intake process with my 14-pages of intake forms and seeing your past records. Let me know if you’d like to work together on a formal consult. Best of luck to you, and may we all be well!

  19. My cousins and I have a family history of Addison’s disease. I want to find answers for myself, and to be able to help my cousins find solutions as well. We all have unusual overlapping symptoms presented for women in their early twenties, with normal BMI’s. For example, night sweats, recurring presyncope upon standing, “good”/low BP, constant fatigue, being out of breath after walking up stairs, etc. I am a non-diabetic and currently seeing an endocrinologist for my hyperinsulinemia/hypoglycemia, and have started a new medication (pioglitazone). I have been tested for anemia and thyroid problems on at least 3 different occasions, with no issues. I have been doing research for a college course on Addison’s disease as well. Why is it that this condition can not be diagnosed early on, in the adrenal fatigue stage, or sooner? I feel like I am being forced to just continually feel miserable (like I have the majority of my life) and wait for my body to fail. It is very frustrating to say the least, getting shuffled around to multiple doctors/specialists, with temporary or little resolutions (like adhd and anxiety medications). I am trying to be proactive about my health, in my recent transition of physicians. I have felt I have suffered my whole life being viewed as a “complainer” and with symptoms that result in getting brushed off. I realize that everyone has a different physiology but with the medical field as advanced as it is, why are there not solutions for cases like this? I would greatly appreciate your opinion.

    1. The problem lies in narrow, rigid and diagnostic criteria that fails to recognize early states and progressing in favor of binary (on-off) diagnostic thinking. I was told 15 years ago that despite the fact that I was symptomatic, my TSH of 4.98 was “normal” and that nothing could be wrong with my thyroid because the “normal range” was for TSH 0.5-5.00. In my experience, endocrinologists are among the most rigid practitioners in this regard. In 2002, the American College of Endocrinology itself redefined the normal range for TSH to be 0.5-3.0, and set a treatment target for TSH to be <2.5 for those undergoing treatment. More than a decade later, the endocrinologists are still mostly stalwart about toeing the line with the out of date normal ranges.

      If I were you, I'd find a skilled ND or functional medicine doc to help you keep a close eye on exactly where a range of blood tests are including: your Addison's antibody levels, ACTH, morning cortisol levels, 4-sample salivary corstisol levels, TSH (<2.5), and TT3:RT3 ratio (<10).

  20. Hi Dr. Morris,
    Three years ago I had severe AF with all the bad symptoms. I supplemented with hydrocortisone and estrogen for two years and then weaned off of both completely. I also cut out some very toxic relationships, reduced stress, and improved my diet. I discovered that I am allergic to several foods, dogs/cats, mold, trees, weeds, etc. I have cut the food allergens out of my diet and am overall doing much much better. I have been getting allergy shots for the animal and environmental allergies. However, this last week, I felt crashed after a shot that was at the next level. Should I discontinue the shots? I really do not want to have a major setback after coming so far!



    1. I cant give medical advice without a full intake, but it you are sure the allergy shots are what are putting you over the edge of tolerance, then it makes sense to drop back on those and reassess adrenal and thyroid function.

  21. You might be interested to know that 2 of the 3 forms of T2 are biologically active, and directly stimulate mitochondria. There are about 10 years of italian rat studies and they’ve been used longer than that in bodybuilders(has more fat burning and less catabolic effect than T3). Its pretty damning that medical science has gotten this one so wrong for so long. You’ll note that the most active deiodinase that converts T4 to T3 also converts T3 to T2..and T2 is the endpoint.

  22. I’ve been told for the last fifteen years I have adrenal fatigue. However, I’ve always had high dhea and, at 52, it is higher than its ever been. My morning cortisol is finally down into normalranges. Sometimes I have high cortisol at night and low in the morning. It fluctuates. My norepinephrine is always slightly elevated, and dhea only keeps getting higher. Also, I rarely have any stress.

    It doesn’t sound like the typical adrenal fatigue. How long can it be fatigued when i have tons of rest and no actual stress?

    1. Sounds like Stage 1 to me. 1 In this phase, cortisol levels are beginning to rise in an effort by the body to compensate for the stress it is asked to endure. However, we find that the DHEA levels are keeping pace with the Cortisol, indicating that the body is still balanced its efforts keep up with the stress placed upon it. Stress comes in many flavors, Look deeper and check factors around your sleep quality, pain levels, sources of hidden infection (teeth), noise pollution, etc.

      1. Emily is right on. Food allergies (IgE), food sensitivities (IgG) and food intolerance (e.g. to lactose, gluten, etc.) and anything that pings your immune system are are all taxing to the adrenals. Thanks Emily.

  23. Hi Dr. Morris,
    I believe I had secondary Addison’s Disease since I was a child. As my blood pressure has always been extremely low, and my salt cravings would have me emptying jars of pickle juice numerous times throughout the week, and asking my mother to put salt packets instead of candy into my lunch box.

    Three years ago, I unknowingly went into adrenal crisis and nearly died. I spent six days in ICU. The doctors informed my family that they could not find the cause of my continued infection, low heart rate and blood pressure, and they should prepare for the worse as I would most likely not return home.

    On the sixth day, an attending physician happened to notice that I had listed DHEA as one of my daily supplements. When she ask why I informed her that my Bioidentical Hormone Doctor had said my adrenal function was low and started me on it. Right then a light went off in the doctor’s head, and she immediately ordered a test for Addison’s Disease. Within a day, I was started on Cortef. I began to improve within a few hours and was able to go home two days later.

    I have continued treatment with Cortef, and I must wear a medical alert bracelet at all times. I have to increase my dosage at the first sign of even a cold, and have injections to give myself should I not be able to keep the Cortef down from vomiting.

    I have done well on Cortef, and I have also continued to take DHEA 5mg, and Pregnenolone 5mg, and DIM for estrogen balance. But I am 53 now and am in my 7th month without a menstrual cycle, and suddenly gaining weight and feeling worse than ever. Do you believe DHEA and Pregnenolone need to be reduced or increased in patients who have Addison’s and are also entering menopause?

    Thanking you in advance for your time and expeditious reply.
    Kind Regards,

    1. Thanks for reaching out, Donna. With menopause, your body will probably be making less Estrogen and Progesterone. This would decrease your need for DHEA and Pregnenolone. You are already on low doses of those, but they may or may not be helpful now. Have your serum DHEA and Pregnenolone levels checked–in the morning before taking your daily doses. You should also check at thyroid function too (TSH, FT4, FT3:RT3), morning cortisol (again before dosing) and a standard lipid panel. Fasting blood sugar, fasting insulin and HgbA1c may be worth a look too if nothing looks out of the ordinary with the previous set.

  24. Hi. I am a 51 year old male. I was normal “size” until age 6 when we moved. I immediately began to gain weight. Was taken to the doctor, who tested the thyroid and said it was fine. In high school I lost about 60 pounds and looked great. Then the fatigue really hit. I was unable to stay awake in my morning classes. I used to sleep through alarms. At age 31 I was put on 100 mg Synthroid. Never seemed to fully help. I was still fat (350lbs), 52 pulse, 97 temp. It was raised through the years to 300mcg. In 2011 a doc added 15mg dextroamphetamine. I woke up and felt normal for the first time since childhood. Lost 175 lbs in a year. My MD retired and because my TSH is undetectable, and everything else is testing high, the new back backed the levo to 250mcg and sent me in a tailspin. I’m now on 150 mg Armour along with the dextroamphetamine, and can barely function. I cry at the sight of a stuffed animal. I can’t function during the day, have fits of rage, and feel like my life has been taken from me.

    1. Levothyroxine alone leaves a lot of people with a normalized TSH and yet with persistent low thyroid symptoms: Weight gain, fatigue, irritability, cold intolerance, etc.. The way to assess thyroid function is to use TSH (0.33), TT3:RT3 (>6). Also check your Anti TPO and Anti TG antibodies and consider other stressors or toxins for why your system went down at age 6. By now, with stimulants, you may well have overtaxed your adrenals: Test AM cortisol and Serum DHEA-S (and possibly pregnenolone and free/total testosterone) to get a snapshot and a 4-sample salivary adrenal test to profile an average day. I would expect that you’ll need to work with a well qualified ND or functional medicine provider to get through all this.

  25. HELP!!! I don’t know where to begin but I’d do know that I can’t live like this any longer….and I have once again given in to Vyvanse after several months because I can’t function any longer….I didn’t develop adrenal failure due to Vyvanse but had to succumb to it to just function…I realize that it is just a bandaid that is doing more harm for me in the future….I’m exhausted!! I had 6 head and neck injuries over a matter of 1 year and 4 months and I’m just getting worse…I can barely get out of bed now…I’m a flight attendant and received 4 of the TBI’s during turbulence…. I’m just becoming more and more exhausted and I’m giving up….I’ve been trying to research the true problems but get too tired after trying to read for even 10-15 minutes at a time…it’s so frustrating. I am starting to suspect Adrenal Failure with possibly some form of POTS because I was diagnosed with “sinus tachycardia after the injuries…I’ve also been diagnosed with vision and brain problems now…severe light sensitivity and pain and the eyes no longer work together…. I also suffer from chronic all over body pain nearly everyday as well as balance issues and tinnitus…and the neck pain is excruciating….but with all of this it’s the extreme exhaustion and fatigue that strikes me down the most…I’ve never been someone to stay in bed all day…I was always vibrant and energetic….Please HELP :-/

    1. Hello Amy. It sounds like you were fine in these other was before the head/neck injuries. If so, I recommend that you keep your focus on the TBI treatment, not other causes for the Fatigue, POTS, etc. Find someone that works specifically with TBI patients using nutritional and neurofeedback interventions. Support for mitochondria and cooling brain inflammation is also often key in recovery from TBI.

  26. This is The BEST And most informative article i have ever read in My 6 year addiction With anphetamines.
    I Only hope others who have struggled With anphetamine abuse find this article And read it.
    Dr. T. R Morris hit The nail on The head… I FINALLY understand why i have been struggling so long With My chronic fatigue And countless other cravings/side effects From years Of anphetamine use.
    Thank you Dr. Morris.

  27. Hello dr. Morris,
    I am in HLA B27 positive female age 50.
    I was hurt at work causing brachial plexus damage.
    I was put on opiates that created opiate induced inertia although the doctors never put me on any motility drugs they removed my colon December 10th of 2013.
    Since this date I have been conically battling my health.
    Treated for reactive hypoglycemia
    ACTH of 1.7
    Cortisol a.m. of 0.1
    I have brain fog memory fog that makes me feel like I have Alzheimer’s I also have had a 30 pound weight gain from 117 pounds to 142 pounds I have muscle weakness extreme fatigue and irritable feelings no sex drive.

    I was misdiagnosed with trigger finger after seeing a neurosurgeon diagnosed with nerve damage treated with a shot in the neck also relieving knee hip and foot pain. The shot also controlled severe diarrhea for 1 week but that has returned.

    Sign desperate for help Carrie Ann Bosworth

    1. An AM cortisol of 0.1 indicates full-on Addisons disease. Get that worked up (is it autoimmune or exhaustion). You may need additional cortisol support short or long term. The shot in your neck was probably cortisone (you didnt say), and that’s why your symptoms went down for a while. I think you have had enough opiates for a lifetime, consider trying high CBD marijuana and get off of the pain drugs completely.

  28. Dr. Morris,
    I did the saliva test and my levels where as the doctor stated never seen before levels. 4 cortisol levels throughout the day were 6am (4), 11am (3), 4p.m. (2), 10p.m. (2), total cortisol output 11. DHEA <1, testosterone (10), estrogen (9), estradiol (9), Estriol (18), progesterone(12), FSH (103), LH (52). All the symptoms you stated I have complained to PCP and it was written off as depression. I delt with this for 2 years. I need vitamins just to function. I was put on Adderall, xanax, and have been on ambient for 12 years. I am 52 and female. I add gastric bypass 13 years ago. I am lost I want to be normal again. Please advise.

    1. I suggest you get checked out by a certified functional medicine practitioner (IFMCP). If you would like a consultation with me, download and fill out the intake forms from the services tab, fill them out in MS Word, forward lab test results and then we can schedule an initial consultation.

      Most conventional docs are not going to know what to do with your salivary cortisol and other hormone tests. They just are not trained in it. Is sounds like are on a daily drug rollercoaster of sleep med, stimulant and antianxiety meds. It no small wonder that you don’t feel normal. Noone would. It may be a long journey to get off of those, but I think you should do everything you can with lifestyle (sleep, exercise, diet, stress management/reduction, counseling), get some expert medical help and begin.

  29. Not sure if this is closed for comments but I just received my Saliva test results
    6-8 am 6 Depressed 13-24 nvm
    11-1pm. 6 normal. 5-10 nM
    4-5pm. 7 normal. 3-8 uM
    10-Midnight. 10 elevated 1-4 um
    It didn’t indicate what stage of Adrenal fatigue I was in, would you know based on the results I provided. I have a stressful job, my mom with Alzheimer’s lives with me, I wake up every two hours Midnight, 2am, 4 am and then 6.
    I have Hashimotoand, unable to lose fat, sluggish….
    My DHEA levels were Depressed (2). 3-10ng
    And progesterone was 16 Depressed. Optimal 22-100
    My functional dr gave me supplements of DHEA low dosage, PURE Adrenal and prescribed progesterone. Does this look in order to what should help with getting my Adrenal/hormones back to normal?
    I am hoping for some positive results.

    1. This sounds like classic phase 2 of maladaption. Low AM cortisol high evening cortisol and low DHEA. You should get your thyroid levels tested carefully. Ideal TSH is less than 2 and ideal TT3:RT3 ratio is at least 10. Even thyroid supplements are a bandaid, but they are an important one. The supplemental DHEA is also a bandaid. Most important is improving sleep, increasing movement, reducing and managing chronic stress, identifying sources of chronic inflamation: food sensitivities, GI dysbiosis, dental issues, chrinic infection, toxin exposure/accumulation, etc.

      I suggest you get checked out by a certified functional medicine practitioner (IFMCP). If you would like a consultation with me, download and fill out the intake forms from the services tab, fill them out in MS Word, forward lab test results and then we can schedule an initial consultation.

  30. I sure wished I lived near you . I would love to come see you . I have been diagnosed with lupus . I have had several very close member of my family die in a four year span . Five of them . Ranging from brother , nephew ,father and two uncle’s of which I lived with growing up . I also got custody of my two grandchildren who were terrible abussed physical and mental . Leaving them with scars on Thier backs and hearts . So with all this stress and on going stress of still more court room battles to come with the children the stress is on going . But I am on the medication for lupus and I am taking Ritalin for fatigue,but still find it hard to move I find it hard to even get off the couch . I used to be such an active person . Even with the meds. I still am gaining weight and can’t stand it in three years I gained thirty pounds . I just am at such a loss of how in the world did I get this way . And what am I going to do . I have all those symtems .I just don’t know what to do . I was test for thyroid . Both my sisters and mother had thyroid cancer and had Thiers removed and Thier perathyroid as well but my doctor told me mine was fine . So here I sit . Still baffled .

    1. I suggest you get checked out by a certified functional medicine practitioner (IFMCP). If you would like a consultation with me, download and fill out the intake forms from the services tab, fill them out in MS Word, forward lab test results and then we can schedule an initial consultation.

      Areas to look into include thyroid: TSH, FT4, FT3, TT3:RT3, Anti-TPO, Anti-TG, ultrasound and cancer screenings. The most critical test there is the TT3:RT3. Your adrenals may well be severely depleted too. You may want to inquire about getting test of your AM cortisol, DHEA-S, Pregnenolone. There are also salivary tests of adrenal function that require 4 samples in a day. Ritalin might have seemed to help you for a while, but may have dug you deeper in the hole. For autoimmune disease, it may be worthwhile to remove all sugar, grain/gluten and dairy from your diet and to take a strong probiotic. If you have had GI symptoms, it may be worthwhile to look into your gut flora with a stool culture for bacteria and fungus, and O&Px3 to check for parasites. There are lots of things to try to tune your destructive immune system down, but nothing is better than sleep, moderate exercise, and stress management/reduction. Supplements may help too, but the foundation of lifestyle is usually critical to success.

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