The adrenal glands are orange-colored endocrine glands which are located on the top
of both kidneys. The adrenal glands are triangular shaped and measure about one-
half inch in height and 3 inches in length. Each gland consists of a medulla (the center
of the gland) which is surrounded by the cortex. The medulla is responsible for
producing epinephrine and norepinephrine (adrenaline). The adrenal cortex
produces other hormones necessary for fluid and electrolyte (salt) balance in the
body such as cortisone and aldosterone. The adrenal cortex also makes sex
hormones but this only becomes important if overproduction is present.

The basic task of your adrenal glands is to rush all your body’s resources into "fight
or flight" mode by increasing production of adrenaline and other hormones. When
healthy, your adrenals can instantly increase your heart rate and blood pressure,
release your energy stores for immediate use, slow your digestion and other
secondary functions, and sharpen your senses.

Our patients’ most common symptoms are fatigue, insomnia, weight gain, and
depression. Does that sound like you? If so, your underlying problem may be adrenal

Every woman who comes to our clinic with these symptoms gets an adrenal fatigue
test, which consists of a series of tests of cortisol levels. And the results — in over
thousands of cases — are remarkably consistent: only 1% have cortisol levels
indicating healthy adrenal function, while 99% suffer impaired function, ranging
from significant adrenal stress to complete adrenal exhaustion.

The effects of adrenal dysfunction can be profound: fatigue and weakness,
suppression of the immune system, muscle and bone loss, moodiness or depression,
hormonal imbalance, skin problems, autoimmune disorders, and dozens of other

The good news is that adrenal fatigue can almost always be relieved. Let’s look at the
relationships between stress, high cortisol levels and adrenal fatigue, and then we’ll
look at how you can give your adrenals more support.

Some Symptoms of Adrenal Dysfunction are:

•        Fatigue
•        Feeling tired despite sufficient hours of sleep
•        Insomnia
•        Weight gain
•        Depression
•        Hair loss
•        Acne
•        Reliance on stimulants like caffeine
•        Cravings for carbohydrates or sugars
•        Cravings for salt
•        Poor immune function
•        Intolerance to cold

Related conditions

Adrenal fatigue is a likely factor in several medical conditions such as the following:

•        Hypotension
•        Fibromyalgia
•        Hypothyroidism
•        Chronic fatigue syndrome
•        Arthritis
•        Premature menopause

Click here for Dr. Firnbach's Adrenal Symptoms Questionnaire (pdf)

Testing for adrenal fatigue

Conventional medicine is truly wonderful at treating disease-state conditions.
Unfortunately its focus on drugs also tends to suppress early-stage symptoms rather
than treat their underlying causes. This can have the effect of delaying treatment
until a disease state has developed. This is true in the case of adrenal fatigue cortisol
testing. In the conventional standard of care, any cortisol level within a very broad
range is considered normal, and anything outside that range indicates disease.

In our practice, we measure cortisol levels at several points in the day to track the
adrenals’ day–night pattern (called the “diurnal rhythm”) using a panel of
saliva tests. We hope to see cortisol elevated in the morning to help you get going,
lower but steady throughout the day to sustain energy, then fall in the evening to
support restful sleep.

In the early stages of adrenal dysfunction, cortisol levels are too high during the day
and continue rising in the evening. This is called “hyperadrenia.” In the middle
stages, cortisol may rise and fall unevenly as the body struggles to balance itself
despite the disruptions of caffeine, carbs and other factors, but levels are not normal
and are typically too high at night. In advanced stages, when the adrenals are
exhausted from overwork, cortisol will never reach normal levels (“hypoadrenia”).

Conventional medicine will detect only the extremes of these conditions, when
damage to the adrenals has already occurred (Cushing’s disease and Addison’s
disease). Within those extremes, you can feel miserable and still be told your cortisol
levels are normal. But by responding to early-stage symptoms of adrenal fatigue, we
can reverse the developing dysfunction.

Should you get an adrenal test?

In general, if you feel happy and well, have steady energy and emotions, sleep
soundly seven to nine hours a night, wake up feeling rested, recover well from stress,
and maintain a healthy weight without dieting, then your adrenals are probably doing

On the other hand, if your energy lags during the day, you feel emotionally
unbalanced much of the time, you sleep poorly or less than seven hours a night, can’t
lose excess weight even while dieting, use caffeine or carbohydrates as “pick-me-ups”
— these are all red flags indicating adrenal insufficiency.

Natural adrenal support — how to restore healthy adrenal function

The first step is to have a full physical exam to rule out disease or other factors. In
our experience, women with mild to moderate cases of adrenal fatigue can see
significant improvement through these steps:(
Adrenal Fatigue do's & don'ts)

•        Dietary changes to enrich your nutrition and reduce
carbohydrates and stimulants.
We also recommend the addition of
high-quality nutritional supplements, including essential fatty acids from fish oil.

•        Stress reduction, including moderate exercise and taking more
time for yourself.
It’s helpful to make a list of your
stressors, especially those that are constant.

•        Get more rest. Your body needs time to heal.

Women with more severe symptoms, or those who have reached complete adrenal
exhaustion, usually need greater intervention. At our practice we use the steps
outlined above with the added natural support of phosphorylated serines, low-dose
compounded DHEA, ginseng, and  licorice.

We personalize the therapy to each woman’s symptoms and test results. (We urge
you not to self-prescribe these substances, as they can have adverse health effects. )
It’s important to emphasize the role of emotional factors. Guilt, pain from past hurts,
self-destructive habits, unresolved relationship problems — your past and present
emotional experience may serve as an ever-present stressor. Dealing with these
problems directly is much more beneficial than trying to compensate for the stress
they create, in the same way that "an ounce of prevention is worth a pound of cure."

In all but the most extreme cases, we expect to see dramatic improvement within
about four months. For mild to moderate adrenal fatigue the turnaround can be
much faster. Remember, you may feel too tired to make changes now, but by moving
forward in stages, you’ll build the strength you need to stay with it. You will love how
you feel when you do!
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