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50 Comments leave one →
  1. April 9, 2010 10:33 pm

    Hi Timothy,

    Have you ever heard of the condition Blepharospasm? My dad has it and has been twitching for a week. Im wondering if you know of any alternative treatment. Ive read that its chronic and gets worse. What are your thought? DO you think that acupuncture may help?

    Thanks,
    Inessa

    • trmorrisnd permalink
      October 1, 2010 11:24 am

      Blepharospasm is the twitching of the eye lid. In most of the cases I’ve seen, reducing stress and caffeine alone took care of it. Outside of that, I think a calcium/magnesium/Vitamin D3 supplement could help too.

  2. Kathy Guevara permalink
    July 2, 2012 7:20 am

    Your write up on adrenal insufficiently and the symptoms has been the best one i have read. i am definitely in stage 3 and I’m struggling with everyday life even though I’m prescribed prenisone. Any suggestions? I was thinking of asking my doctor for a stimulant just to make it through my days. I’m a single mom of 2.

    • trmorrisnd permalink
      August 14, 2012 6:04 pm

      No on the stimulants. You’ll just burn out faster. I’d like to see your responses to my long intake form, a weeks worth of my diet/symptom/activity/sleep diary, your results from a 4-Sample Salivary Adrenal Stress Index test, some thyroid tests, and a CBC. You can can call or email me to set up a phone, online or in-person consultation on this and other important health matters.

  3. sandra permalink
    July 11, 2012 9:15 am

    No doctor i have been to is taking me seriously. I live in Fl and im desperate for answers. My heart races my Bp is elevated from time to time i have all the symtoms of adrenal fatigue stage 3 and im confused why they cant test me acurately and give me a diagnosis? Ive been told i am bi polar and everything else in between and other doctors say im not. I need help. Please

    • trmorrisnd permalink
      August 14, 2012 6:02 pm

      Sandra/All: A racing heart rate and elevated BP can be from anxiety or a defect in the conduction system in your heart. Either, plus stress from life or a psychological condition (and I am NOT suggesting that you have one or not) can cause deep fatigue and adrenal weakness. Regular MDs are not going to know what to do with you. They just don’t have the training, courage or curiosity to figure this out. You need to see a good (4-year medial school graduated and licensed) ND or a Functional Medicine MD that has received advanced training from the “Institute of Functional Medicine”. Any other doc may give you a woo-woo run around, and it sounds like you really dont need that. First off, consider seeing a cardiologist and have an EKG and/or stress test done. Then, if your heart checks out, have a 4 sample salivary adrenal stress index test run to assess your adrenals.

  4. Bobbye Casner permalink
    July 16, 2012 5:01 pm

    Hello. I had blood work done for a check up. Results included a cortisol of 1.1 of which the lab listed as low. Blood was drawn at 11:15 am. Since this level was low, a second blood sample was drawn for cortisol only at 9:15am, and this one was reported to me as normal. This puzzles me. Should I investigate this further. The symptoms I read sound like what has been happening to me. Your opinion and or advice is greatly appreciated.

    • trmorrisnd permalink
      August 14, 2012 5:54 pm

      Hi Bobbye. That low cortisol could be a concern, or it could be nothing. What is the stated normal range for the 11AM cortisol? Any why were they looking at cortisol at all in your case? There is very little I can do online, because most patients can’t guess what I need to know to make an accurate assessment. I’d like to see your responses to my long intake form, and with a low late morning cortisol I’d like to see the results of a 4-Sample Salivary Adrenal test. You can can call or email me to set up a phone, online or in-person consultation on this and other important health matters.

  5. David permalink
    September 22, 2012 5:21 am

    Hi, I am new to this message board thing, so forgive me if I’m doing it wrong. I am a 43 year-old male who has been diagnosed with ADD since childhood. I have been on and off of stimulant medications and anti-depressants for many primarily the last ten years. This very last year I came off of the medications (Vyvanse 70mg & Lexapro 20mg). I also stopped alcohol and caffeine all together, have been eating extremely healthy (fruits, veggies, nuts, only healthy essential fatty acids, vitamins, probiotics), and exercising daily. Despite of this rather extreme effort: During this last year, I have been EXTREMELY TIRED, irritable (couldn’t really even stand myself), and basically not animated to an extreme. Prior to this last year and after an extremely stressful year, I have been having digestion issues (acid reflux at bedtime), trouble sleeping (staying asleep), unrelenting acne, and very big decrease in my sex drive. I have just recently started taking the Vyvanse again in an attempt to survive, but I am concerned that this will only compound the problem. Oh ya, I lost my job due to the recession and currently do not have any medical insurance. Any suggestions are welcome.

    • sysad permalink
      May 31, 2016 2:35 pm

      I would be irritable too, if I stopped taking stimulants after many years…

      you are reaching to ground yourself and to be ‘yourself again’ as someone with this abundance energy, but perhaps what you seek is not a base line self but a result of the stimulants?

      depending on how long you were treated with psychiatric drugs i would think more than a years’ worth of effort may be required for your brain and body to adjust 🙂

  6. Exhausted permalink
    January 30, 2013 10:32 am

    I’m an 18 year old who out alot a pressure on myself with sports until this year I just stopped enjoying it and very tired. Currently take adderall vyvanse lexapro and coffee and still could lay in bed and do nothing all day. I hadn’t taken anything until this summer noticed I was really tired so started caffeine pills and then moved on to adhd pills, then lexapro, then combining it with coffee. And it just hardly does a thing for me anymore! Also my ferritin level is 35 and thyroid is fine!

    Does this sound like adrenal fatigue?

  7. January 31, 2013 5:03 pm

    You probably are experiencing some adrenal fatigue, but all of your symptoms could also be explained by the development of “tolerance” to or “dependance” on the various stimulants you have been taking. Our bodies always have a response to being pushed around by stimulants in order to decrease the effects. The response starts with tolerance (where you need stronger doses to get the same effect) and can evolve into dependance and even addiction. Like anyone taking stimulants, you’ll have to pay the piper for all that borrowed energy sometime. I suggest you bite the bullet and begin to steadily wean yourself off ALL of the stimulants (including dietary caffeine) and then see how you feel. It will take time (perhaps 1-2 months), and you can expect to feel tired and need a lot of rest. Because you are on prescription medications, you should do this under a doctors supervision. High quality food (e.g. mostly protein, vegetables, whole fruit, and healthy fats) and regular mild-moderate exercise would probably help too.

  8. Jenny Barnum permalink
    February 16, 2013 10:12 pm

    Really interested in your information and knowledge on adrenal fatigue/exhaustion. I am in between stg 3 and 4…I am an ED provider, sick father, professor, single, own my own house, and I am everyones “rock.” I need help…I feel if I dont get it soon I could end up dead…

    • Christine permalink
      July 1, 2013 11:59 am

      I am late stage 3 almost ended up dead about 7 months ago, please quit trying to be every ones rock or you’ll not be there for anyone, I am driven as well and expect a lot of myself, I have realized everyone will have to do without me if I don’t get some down time. Adrenal issues are so hard for people to understand, looking at you they just think your are fine because you look fine. I am told at this late of a stage it will take me 2 – 3 years to heal. if you are not sleeping, nutmeg about 1 – 3 tsp. about 5:00 pm for a bedtime of 9:00 which you should be hitting the bed at that time with your condition will make you sleep better than any medication, however if you take too much you will be stoned in the morning. your adrenals rest from 10pm till 1am, and if you aren’t sleeping they won’t get rest. eat lots of good protein, try juicing at least once a day with raw veggies, don’t eat refined sugar, DO NOT drink coffee or take any natural or unnatural stimulants, you probably need to find a Naturopath. Massages are good and help the muscle, I have to do magnesium and vitamin C by I.V. cause my digestion cant handle it, Glutagenics by Metagenics is awesome for healing the digestive lining and getting rid of diarrhea which you probably have in this late stage, and you need to get rid of the diarrhea or you won’t be able to absorb any nutrition, I take apple cider vinegar pills every time I eat anything because my adrenals are so gone they my body won’t make the acid needed to digest. Massage on your liver and digestion area helps and need to walk every day for 20 minutes at least, also get sun about 20 minutes a day, or lay in tan bed 8 minutes a few days a week to build your vitamin D as your immune is weak and UV is much needed at this point, I have to take amino acids because my muscle has been depleted, my joints hurt all the time and my bones are very sensitive. Try to be happy, watch comedies, listen to inspiring music, be around positive people and people you know need to read this websites information on what stage 3 does to you so they understand where you are. I have had kidney problems, digestion problems, liver problems, you name it, severe organ pain inside your body happens as well, I found some relief from that by drinking liquid cayenne in water about 1/2 tsp. You can get high blood sugar and low blood sugar on a dime cause your body is hypersensitive and that will make you feel horrible, so exercise and water helps get rid of high blood sugar and eating an apple will get rid of low blood sugar, get a blood sugar tester and use it when you feel bad, also at this point I got high blood pressure with edema (swelling in hands and feet) bad for your arteries, I use bloat away which gets the water weight down, this can be an indication of kidney issues onset from adrenal fatigue….. hair falls out at this point too, and is caused by stress and can be from lack of amino acids as well. Hope this helps somebody, I have been through a lot and would at least like to help others so they don’t have to suffer so much.

    • July 1, 2013 12:16 pm

      Hi Jenny. I’m sending you an intake form to fill out so we can start the consultation process.

  9. Siobhan permalink
    September 13, 2013 6:41 pm

    Hi, I suspect I have adrenal fatigue. I was recently told I have a thyroid imbalance, (low t3) and have extreme fatigue everyday. I am taking Naturethroid and began an adrenal supplement. Do you have any ideas for treating the adrenals? Supplement recommendations? The fatigue is very bad and this is hard as I am only in my 20s. Do you know how long it takes for the adrenals to heal? Thank you for your time and help.

    • September 13, 2013 7:52 pm

      If you haven’t already, I’d recommend that you get your thyroid antibodies and RT3 tested and also get a 4 sample salivary cortisol assay (or at least a serum AM cortisol). That way, we’d have a better idea of what your adrenal and thyroid function actually is, and we’d be able to track your recovery. Thyroid and adrenal supplements can help, but in order to heal, the most important factor in recovery is how well you reduce and otherwise address the source of your stress.

  10. Siobhan permalink
    September 13, 2013 8:02 pm

    Thank you so much for gettin back to me so quickly. I will look into these tests and also I have been working on eliminating the stressors in my life: work and relationships. I have been gluten free and dairy free for 6 months. I hope both thyroid and adrenals improve. Thank you.

  11. Lisa permalink
    October 14, 2013 12:28 am

    Hello dr Morris, i am 54 and pretty much have always been healthy until the last 5 or so years. I have been dealing with thyroid issues been on iodoral and nature thyroid been vit d deficient and have a nodule now 5 cm. I had hoped to shrink it with proper help supplements herbs etc . There were times it almost seemed to have shrunk giving me hope. Now I’ve been diagnosed with hashimotos, seems like the next epidemic . I have a store for women and I am astounded at how many have or are about to have their thyroids removed! I have been to an endocrinologist who raised me nature thyroid from 60 – 97.5 makes me feel hyper before that I tried another nature path and the supplement I was given made me feel anxious and swollen or inflamed in my throat below the collar bone. I did not want to have my thyroid removed. But now I’m so tired and worn down thinking of all this. Would you refer an endo or thyroid surgeon if you don’t have other advice at this point ? I appreciate it very much. Thank you

    • October 14, 2013 11:05 am

      You may have a “hot nodule” on your thyroid gland that needs to be treated or removed. With a large nodule involved, I think you should probably see the endocrinologist. The iodoral iodine may be feeding that nodule. I am not a fan of wither iodine or dessicated thyroid (nature-thyrpoid, armour thyroid) for hashimotos. The iodine can drive you to produce too much thyroid hormone, and the dessicated thyroid can easily make your thyroid-antibody levels go up (worse). Instead, I suggest straight T4 (synthroid) and T3 (cytomel), with no extra iodine. Adrenal fatigue/insufficiency should be checked out with a serum AM & PM cortisol, and DHEA test (or a 4 sample salivary cortisol test). Food sensitivity testing IgG may also be a good idea to help settle your immune system down further if you want to avoid a complete thyroidectomy. You can consult with me for more details and if you want me to follow your case and make recommendations. May we all be well.

  12. Kelsey Graves permalink
    August 21, 2014 11:09 am

    Hi Dr. Morris,
    I am 32 yrs old diagnosed with Candida at age 3, Hashimotots at 28, Type 2 Diabetes at age 31. I have anxiety, trouble sleeping, and have found it impossible to lose weight. I also have very low Vitamin D, and some elevated liver enzymes from a fatty liver. I believe that all of my issues are caused by my candida, but I haven’t found a doctor that is willing/or knows enough about it to help. I have been slowing detoxing off sugar/yeast with intense migraines, muscle/joint aches, stiff fingers, fatigue, and itching. What would you suggest?

    • August 21, 2014 11:36 am

      Hello Kelsey. Thanks for reaching out. It sounds like you could will be having the classic symptoms of a yeast die off reaction. I don’t think the treating the yeast alone Will be the answer to all your problems though. There was an underlying reason why the yeast overgrowth too hold in the first place. Good functional naturopathic medicine is all about taking a look at the whole patient and identifying the root causes of symptoms, infection, illness and other physiologic dysfunction. So I said just to get yourself to me licensed Naturopathic Doctor, or a certified functional medicine practitioner. I will send you my intake paperwork separately in email, and we can work together in person in Seattle, WA, or through remote consultations.

  13. Allie Dolan permalink
    September 5, 2014 1:33 pm

    HI Dr. Morris,
    I am 42 years old, I was diagnosed with Hashimoto’s when I was 25 and Addison’s when I was 40. I have ADD and am low in D and Iron. I think that I may have Candida issues and am exhausted all the time. I see the endo regularly, but would like more support on how to be able to live normally with energy and vitality. What would you suggest?

    • September 5, 2014 4:20 pm

      Hello AD. To practice good naturopathic/functional medicine, I can’t just shoot from the hip with ideas for therapy and have a good chance of really helping you. If you find a doctor that would do this, I’d suggest running the other way. What you need is for a skilled and attentive physician to carefully take your case history and consider the most likely underlying causes of your symptoms.

      Thinking broadly, the source of your troubles could easily be multiple contributing factors including things like: the long term side effects of medications you took for the ADD; digestive or nutritional deficiencies; GI dybiosis (bacteria, parasites, candida or other yeasts); or even things like long-held problematic belief systems and unexamined stress response patterns; sleep disorders; persistent inflammatory conditions; sex hormone imbalances; symptoms related to elevated insulin and metabolic disorders; an overload of toxins or xenobiotics; chronic viral infections; the list goes on. That’s why it takes a true versatile expert to give true care. In my opinion, far too many doctors in alternative medicine are married to one or just a few “shticks” or gimmicks that they herd trusting/desperate patients into.

      There are lab tests that might well shine a light on the cause of of symptoms such as looking into your thyroid and adrenal function in ways that conventional endocrinologists don’t even know to look for–let alone interpret correctly: RT3:TT3 ratio, salivary cortisol panels, serum DHEA-S and Pregnenolone to name a few.

      Back to my point, what I really suggest is getting properly assessed by an outstanding licensed ND or by a IFM Certified Practitioner (IFMCP). If there are none of these in your area to see you in person, you can send me an email and we maybe able to do formal consultations remotely via phone/email/Skype. My fees are listed under the services tab of this website.

  14. Sarah Dusch permalink
    September 15, 2014 6:44 am

    Dr. Morris,

    I am currently seeing an IFMCP in my area and being treated by an adrenal fatigue expert by phone. I had a lot of stress for several years and “fell apart” suddenly last summer. I had such bad abdominal pain that I could barely eat or drink. After 8 months of that ( conventional medical tests couldn’t find anything wrong), I went from 108 pounds to 86 pounds. I found a book on adrenal fatigue and a local DO put me on hydrocortisone. I was bedridden for 3 months and thought I would die. Fortunately, the abdominal pain subsided and I could eat more than 800 calories a day. The adrenal fatigue doctor diagnosed me as stage 4 AFS and also liver congestion (reacting to everything). Just started being able to do charcoal liver patches and recently glutathione to help clear my liver. Found a IFMCP near me and, he found vitamin b, probiotic, pancreatic enzyme deficiencies, some sort of dysbiosis (awaiting test results) and found I have the two MTHFR gene deficiencies. I also was diagnosed with ADD in 2007. I am a 52 year old, menopausal woman. I have been able to gain a little weight (up to 92 pounds) , but have lost a lot of muscle. Several of my doctors have said it could take 2 years or longer to recover. I started taking Xanax for anxiety 5 months ago ( 1/2 pill twice a day) but, am starting to need more. I have also developed a bad case of depression that my doctors said is hampering my recovery. I don’t want to take anti-depressants since I react to everything. One doctor suggested SAM-E and I’m going to try that. I can’t laugh, nothing matters, and I have little hope left. I am concerned that I’ve been on Xanax too long and it is adversely affecting me as well. How can I hang in there for the duration? Thank-you, Sarah.

    • September 19, 2014 5:17 pm

      The number one thing I would recommend is to address the source and perpetuation of your anxiety. It will be difficult if not impossible for your adrenals to recover function without removing the source of the stress. More Xanax is not the solution. If I were you, I would consider other natural amino acid supplements that can reduce anxiety at least two behavioral approaches among options such as: mindfulness meditation, breath training, Yoga, Qi-gong, Tai-Chi and cognitive behavioral therapy.

  15. Tesia Mcgallagher permalink
    September 15, 2014 8:47 am

    Hi Dr. Morris,
    I am 40 yrs old and have severe ra. I found this site because I’m desperately seeking a answer!
    I have all the signs of adrenal exhaustion stage 3or4 according to your article. Just in the past few months my over health has declined tremendously!
    I’m am on so many meds that can have adverse effects. I was diagnosed with ra 13 yrs ago and did well until two yrs ago. I’m doing actemira infusions for the ra, I take 10 mg prednisone every day for the past two years, I’ve tried to ween off but my ra flares so bad I have to go back up, but recently it hasn’t helped I’ve been in a constant flare. My pain is horrible. The fatigue is so bad I can hardly walk around my house without having to sit down, I drink coffe all day, I take norco for the pain, adderall for energy(it helped at first,but not now) I take neurotin for neuropathy, 40 mg Prilosec, naproxen as needed, Allegra d, Valium, I’m sure there’s more, but I have so much brain fog that I can’t remember things often. I take all of this and nothing is helping now! I feel worse daily.
    I am a member of and ra support groug on fb and ask tha question of things I’ve recently started experiencing, recently (2wks) I get the shakes just out of no where and my vision gets cloudy. And another member whom went to get her PhDs but could not complete because of complications with ra told me about adrenal exhaustion and how dangerous it could be!
    I am so stressed and depressed because I’m always in pain and cannot function well on a daily basis! I haven’t seen a dr or been tested. I don’t even know which kind of dr to see for this?! I need to find out what is going on soon! I feel like my body is shutting down rapidly!
    Another thing I need to mention. I took synthroid for years for hypothyroidism and oddly after starting my first biologic for ra (humira) my thyroid dr said the thyroid was normal! I thought this was very strange?! My pp has tested me and said it was in normal range?! I haven’t although been tested since feeling this bad.
    My pp also recently prescribed pristiq for depression, but I haven’t taking in for the reason that I’m afraid of how it will react to all the other meds?
    Any answers, suggestions,ect…would be greatly appreciated! I need help, I know there’s something happening! My body is telling me this. Thanks!

    • September 15, 2014 9:24 am

      Hello TM. I’m sorry to hear of your troubles. There’s little I can do over email without a complete history and intake. It does not surprise me that the Humera brought your thyroid back into the normal range. You probably had some degree of autoimmune thyroiditis that was, for now, suppressed by the biologic drug. It’s worth getting your adrenal function tested with a four-sample salivary cortisol and also a serum DHEA-S and Pregnenolone. Conventional endocrinologists will not know what to do with this information though. Get a full thyroid workup: TSH, FT4, FT3, TT3:RT3 ratio. Again, you’ll need an IFM certified functional doctor or a very well trained (and licensed!) naturopathic doctor to interpret these tests correctly. Best of luck. Let me know via email if you’d like to work towards a formal consultation where I could really dig in.

  16. Tesia Mcgallagher permalink
    September 15, 2014 10:13 am

    Thank you for responding. I will try to find a dr that you referred to and have test done. If no luck, I’ll be contacting you. Thanks again!

  17. Jeni permalink
    March 6, 2015 6:29 pm

    I recently under went a week long liver detox suggested by my doctor. This resulted in my eczema and Epstein Barr to flare up. It’s been almost a week since I completed the detox and I’m still having symptoms from them.
    I’m also dealing with a hormone imbalance that has resulted in me changing my diet to a high fast/low carb. Things are coming around but there has been no feedback as to why this happened. Could they be connected? Can you help?

    • February 24, 2016 11:31 pm

      Connected? Sure. A week long liver detox could be and do lots of things depending on the components. So could a hormone imbalance, and what ever is underlying that. Stress itself is a great trigger for flareups in any inflammatory disease. Digestion and GI flora are worth looking into too. It’s may well be a host of little things. I could help you sort it out, and so could a good ND or IFM trained IFMCP graduate (MD, DO, DC, ND, LPN, PA, CN). I see patients just a half day a week presently as I am working as a medical education director at IFM. They have a find a practitioner link. IF you like to work with me, please send me an email, and I will reply with the rather extensive intake paperwork.

  18. April 8, 2015 7:26 pm

    Dr.Morris,
    Hello. I don’t know if you can help me but I feel that I just can’t go on anymore, and I am losing everything. I will try to make this as brief as possible. Hx of hypothyroidism for over 15 yrs and on synthroid with cytomel added appx 3 yrs ago. I am 48 but have has issues with perimenopause for over 6 yrs. I went to an integrative md dr in January for help with sex hormones..I was suffering from fatigue, insomnia and hot flashes. I had taken bio-identical estogen, progesterone and testosterone in the past. Battery of tests 24 hr urine, saliva and many blood test. Dr. dx me with hashimoto and corticoadrenal deficiency. At the time I was taking 125mg of synthroid and 5mg of cytomel. My tsh was elevated and t3 and t4 were on the low side. The Dr. increased me to 175mg of synthroid and 25mg b.i.d. of cytomel. Also put me on bio-identical estrogen with DHEA added, testosterone and progesterone along with multiple supplements. Fast forward one month and I started having edema in my lower extremities, severe exhaustion, salt craving, (weird I know) nausea, heart palpitations almost like an afib, shaking and anxiety like I had never experienced. I went to my pcp and was put on a beta blocker to slow down my heart and xanax for the anxiety and stopped the cytomel completely and decreased synthroid to 150mg. My tsh at the time was 0.010, t3 11.53, t4 2.02, potassium low and BUN elevated. It took some time for some of the symptoms to resolve.
    Had my labs rechecked about 2 weeks after stopping the cytomel tsh is now 0.052, t3 and t4 are lower. My problem is I am still almost completely bedridden. Sx include extreme fatigue, weakness, otorthostatic hypotension, nausea, dizziness and increased heart rate when standing, inability to sleep even with ambien, trembling hands, dry skin, hair falling out and very puffy eyelids. Went to a functional med dr last week he’s going to look over labs between appts. He ordered thyroid U/S, and told me too eliminate proccessed foods, cut out caffeine and to sleep 8 hrs. I liked him but I feel like no one’s is addressing my adrenal problem. I have always had a lot of stress in my life..I’ve worked 15 years in a busy er and I’m caring for my adult disabled daughter, so high stress I’ve always handled. My husband was dx with stage 4 renal ca in June though and that has added much stress. I haven’t worked for almost a month, was told today if I don’t return next week I will lose my job! That will destroy us as I carry the insurance for all. I’m thinking of trying a stimulant drug to see if I can work at least. What are your thoughts on this? This may be the end of me as I no longer can handle even small amount of stress. Also my cortisol levels are low, normal, normal and high. Thank you so much for any imput you may have!
    Laura

    • April 9, 2015 8:50 am

      Dear Laura. While it may be possible to patch you together for a time with additional “natural” therapies, it’s honestly hard to imagine that you will truly recover without concerted efforts to address the causes of your troubles with stress reduction, stress management, care-giving assistance, and counseling.

      You are right in that it does not appear that anyone is addressing your adrenal insufficiency. Have someone run an am or AM/PM cortisol on you (covered by insurance) or a 4-sample salivary cortisol. Both would give some idea of adrenal output. I would guess that you are generally low in cortisol output, but that it ramps up at the end of the day. Licorice tea or DGL in the AM would help preserve the half life of what cortisol you are producing. Rhodiola & Maca may also help as might Holy Basil, Ashwaganda, and Siberian Ginseng. Caffeine and stimulants are not going to help you. I’d avoid stimulants completely and minimize caffeine intake to 0-2 cups before noon, none after.

      It’s worth considering and ruling out Addison’s Disease: sodium, potassium, cortisol, ACTH to start. Addisons adrenal antibody test, and perhaps an ACTH challenge test might then be indicated.

      It sounds like you may have been over-medicated on synthroid(T4) and cytomel(T3), yet no-one has looked at RT3. I would demand that a doctor run both RT3 and TT3. If the ratio of TT3 to RT3 is <6, then you have a T3 conversion isssue. The solution/bypass of the T3 conversion issue would be to reduce T4 dose and to increase T3. It's impossible to know where you will land exactly, but I expect that something closer to 50-100mcg T4 QAM and 5-15mcg T3 QD-BID would be better for you than 150mcg of synthroid.

      Truly though, you have obviously been through a lot of stress and care-giving at home and work. You need long term rest and stress management and reduction. Getting help with the care-giving of your family and counseling and mindfulness based stress reduction (MBSR) for you are really important.

  19. Charlotte permalink
    May 1, 2016 5:24 pm

    Hi Tim,
    I never leave comments but I just needed to say a huge thank you for your article: https://trmorrisnd.com/2010/03/15/adrenal-fatigue/
    I’ve had Hashimotos for 13 years and over the last year I’ve developed into (based on your chart) stage 3 adrenal dysfunction. I’ve been seeing various doctors and have finally found a good local integrative practitioner here in Australia, so just beginning to understand the connections … but no-one has explained it better or more clearly than your piece here. Thank you!!! Your article really connects the dots and explains how I can better take care of the whole system. Greatly appreciated,
    Charlotte

    • May 13, 2016 4:11 pm

      Thank you, Charlotte! Making the connections between the HPTAG (Hypothalamus-Pituitary-Adrenal-Thyroid-Gonadal) hormones and our health is vitally important. Not only can conventional medicine do a better job of identifying hypothyroid conditions (i.e. looking for TSH >3.0; TT3:RT3 <10, etc.), we can make connections how it is adrenal cortisol and DHEA issues that frequently precede Thyroid problems, and how it is Thyroid problems that often precede gonadal hormone (Estrogen, Progesterone, Testosterone) issues.

  20. mayjunejuly permalink
    May 19, 2016 4:07 pm

    I’ve been suffering for so long, I’m seriously considering just putting an end to it all. I can’t fall asleep at night; I can’t wake up in the morning. When I do wake up, my stomach feels sour, I feel nauseous, and the only thing that helps is cannabis. I can’t fall asleep unless I smoke. I can’t eat unless I smoke. And the only foods I can eat anymore are mild foods like potatoes, rice, cheese, avocados, some fruits, some vegetables, ice cream. I am anxious and depressed at the same time, all day, every day. I can barely work, I can barely stand to be around people, I have no tolerance for anything, I am quick to anger, in part because I feel so sick all the time. I’ve been studying Dialectical Behavioral Therapy, thinking maybe my problem is partially psychological — maybe I’m bipolar or I have borderline personality disorder or some other emotion regulation disorder. But, regardless, I’ve been depressed and anxious for more than ten years, I’m sick to my stomach every day, I can’t eat, I can’t sleep, and nothing helps. I’ve seen several psychiatrists over the years and been prescribed several antidepressant medications, none of which seem to help. I’ve also been taking a benzodiazepine for a long time, longer than I would think anyone would let me, and I wonder if my tendency toward anger and aggression could be a side effect of the long term use of this drug, although none of my doctors have indicated this. I am sick, and I feel like no one takes me seriously, everyone thinks that all I do is smoke week and drink, they don’t understand that all I’m trying to do is stop the pain. I need help.

    • October 24, 2016 2:43 pm

      I believe that would benefit from a comprehensive naturopathic or Functional workup from someone that does not have a refined shtick (where they try to treat everyone for the “syndrome de joure“. Places to look include food allergies/sensitivities (consider doing a comprehensive elimination diet), sleep apnea or other sleep disorder, thyroid function (from a functional lens–NOT the conventional testing/interpretation), adrenal function tests, other hormones (DHEA, Pregneolone, Sex hormones), etc. It may take time, but you deserve a thorough approach.

  21. Calista Railsback permalink
    June 5, 2016 12:27 pm

    I believe I’m in stage 3 of adrenal fatigue. I was diagnosed with mono 2 years ago and ever since then I’ve never felt the same. The last 3-4 months I feel like I’m slowing dying. I’m a mother of 3 young kids and I can’t do anything. I’m barely functioning. My doctor prescribed Armour Thyroid, phentermine, an anti depressant and a sleep aide to help with my symptoms. I’m at a loss and feeling worse everyday.

    • October 24, 2016 12:13 pm

      I’d get a 4-sample salivary cortisol test to confirm your suspicion, ASAP. Also measure serum DHEA-S and possibly Pregnenolone. Make sure to also have someone look at FT3:FT4 ratio and RT3:TT3 since you are on thyroid support and still tired.

    • November 10, 2016 3:33 pm

      Thank you for reaching out. It sounds like the conventional medication route to cover up your symptoms is not working. I suggest you partner with a well trained ND or an IFM trained certified practitioner and look for (and address) the underlying causes of your troubles.

  22. Maureen permalink
    October 23, 2016 1:40 pm

    Hi Dr. Morris,

    I’m 55 and was diagnosed with Stage 1 breast cancer 3 yrs ago, treated, and all seems good now. It was a wake-up call and that plus my Nutritional Therapist sister have sent me into serious changes in habits, esp. eating. I’m a Weston A. Price Foundation member, eat only organic veggies and grass fed beef, and so on. But I am a sugar addict, with varying degrees of success in staying off the stuff…

    I discovered your website after looking at the IFM website (I live in the Seattle area), after reading Dr. Kharrazian’s book “Why isn’t my brain working? (Haven’t finished it.) I’m writing because, as part of all this cleaning up my act, I elected to taper off my 10-years on citalopram. Tapered off over 4 months, and completely stopped about 3 weeks ago. Now I’m miserable. I know about “discontinuation syndrome” but I’m an emotional wreck. Crying at the drop of a hat, very irritable, feel lousy about myself and my life. Some days are OK, and it has gotten slightly better, I think…

    My biggest fear is that this is the new normal – because the extra benefits of the citalopram, I found, were an overall lowering of anxiety and irritability, and a lightening of my outlook. So now that I want to be “clean” of the medication, how do I regain those things – sense of calm, peace, even happiness? Is this something you could help me with? Is my brain sick and will I get more insight as I read Dr. Kharrazian’s book? I don’t even know where to begin, since I’m already doing a lot of the “important” things re sleep, diet… not so much on exercise (I go up & down on this, it’s a real struggle for me). Or should I really just suck it up and try a little harder – focus on exercise, meditation, even better diet?

    • October 24, 2016 12:07 pm

      Sleep, Diet, Exercise, Stress management can not be overemphasized. However, it take energy and dedication to make lasting changes there. I think you might benefit from a nutritional therapy that supports the body’s natural serotonin production: 5HTP (50-200mg 1-3x/day away from food). If that does not help. You may have an additional adrenal or thyroid issue at the root. Thyroid function can not be assessed with TSH and FT4 alone. A full workup would be TSH, FT3:FT4, RT3:TT3, TT4 and possible antibodies (TPO, TG). AM cortisol and DHEA-S testing provides at least a small window into Adrenal function. If you went through Chemo, your postmenopausal sex hormones (Estrogen/Progesterone) were already low, but may have then stopped abruptly (ala: chemical menopause), and that may be a another area to consider investigating/supporting.

    • November 10, 2016 3:28 pm

      The best way to support brain function is with sleep, exercise, nutrition (avoiding carbs/sugars), reducing and managing stress. Sometimes we need some physiologic help to get motivated. Many people find that 5HTP 50-300mg 1-3x/day away from meals is very helpful. Something else to try for anxiety is L-theanine 200-400mg 1-3x/day away from meals. Also get your vitamin D levels (25-OH-D3) checked. Most of the patients I see in Seattle that work inside need 4000-6000 IU of Vit-D3/day. It’s well worth double checking your thyroid and adrenal function too. Gut inflammation from food allergies/sensitivities and dysbiosis is something worth considering too, as there is are now clear connections between these and depression/anxiety/brain fog. A well trained ND of IFM certified practitioner can help you look into these areas. If you’d like to work with me, please first check out the services tab of this website.

  23. Robyn L Brooks permalink
    November 10, 2016 2:04 pm

    I have been treated for Hashi’s for 30 + years with Synthyroid, Levo, and now Armour. My hair continues to fall out, and not much is left. Constipation has been a constant, brain fog daily, irregular heart rhythm, dry skin, itchy hands to name a few of the symptoms. I asked my endo about these and have been told that the ATA recommend Synthroid. but she will give me Armour if I insist. All other symptoms are really not in her specialty. She is not alone my primary says just about the same. My My ThyroglobulinAutoantibody test came back 1341.8 IU/mL and yet I have been told that the body always has antibodies and I should not be looking for problems. The view of my health does not seem to be an issue for Western medicine – no holistic view or even a belief that the body is a complete unit and if one thing is wrong the whole unit suffers. I cannot see living a long full life if all this continues.
    Can you help?

    • November 10, 2016 3:17 pm

      Thanks for reaching out, Robin. The short answer is yes. I can help or some other ND or IFM trained practitioner can help you. It’s easiest to work with someone in your own state, but if you can not find someone, I may be able to be of some assistance remotely. You are 100% right that you need to consult with someone with a more evolved and modern view of thyroid issues with an eye for connections to other body systems. You’ll want to get your AM cortisol and DHEA-S to evaluate adrenal function and then get a fresh and more comprehensive thyroid TSH, FT3, TT3, RT3 and TT4.

  24. Tina permalink
    August 18, 2017 8:48 pm

    Hi,

    While I was looking up Adrenal Fatigue and Lupus, I Read an article of yours on Adrenal Fatigue and ADD. I was diagnosed with Lupus SLE some years ago, and given an antidepressant for situational depression – with a minor ‘discussion’ in adrenal fatigue (I was facing domestic violence and dissociated memories of childhood abuse). And more recently diagnosed with RA also.

    Only recently have the local doctors realized the fatigue was coming from a different source than merely arthritic pain – they feel it’s Lupus related, but don’t acknowledge adrenal fatigue diagnosed by a naturopath.

    I’ve been doing all the diet stuff (although I don’t probably eat enough), still trying to get exercise consistent, and supplements seem to only work for a while and then plateau. My immune system just wouldn’t dial down, so I’ve recently been put on methotrexate – which has helped with pain, and they’ve put me on Trintillex – which for the first time has given me relief from fatigue and brain fog.

    I can’t help but shake the feeling though that these measures are more of the ‘treating the symptom’ rather than the illness(s) or causes??? And that there’s crossover on causative autoimmune and Adrenal malfunction on several fronts??? Am I wrong on this??

    Anyway, just querying a hunch.

    • August 19, 2017 4:02 am

      Absolutely. The connection between adrenal function, specifically cortisol, and the immune system is well documented. Extreme stress from long term trauma can easily drive patients through stages 2, 3 and 4 of adrenal insufficiency/failure and be a fundamental factor in the development and exacerbation of autoimmune disease. The conventional rheumatologist are not trained to look for (or see) these connections, at least not academically. Get yourself to a well trained ND, or a an IFM certified practitioner.

      • Tina permalink
        August 19, 2017 7:05 am

        Thank you

  25. Anne permalink
    August 27, 2017 9:31 pm

    Dear Dr. Morris,
    Do you have any experience treating Morgellons?

    • August 28, 2017 1:57 pm

      Thank you for reaching out, Anne. I do not have experience with Morgellons. In my experience, a broad functional medicine approach would include: optimizing digestion, nutrient status, GI microbiome, and lifestyle factors (sleep, movement, and stress), screening for food allergies and sensitivities and optimizing immune, adrenal and thyroid function would likely help people with most, if not all, chronic conditions. That’s what I could offer. If you’d like to explore working with me, fill out the intake paperwork in MS word and send it to me along with salient prior lab and imaging work-ups. Then we can schedule our initial consultation.

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