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Ten Signs that You Have Adrenal Fatigue

January 17, 2018

 Are you tired in the morning? Do you have chronic lower back pain? Or, do you feel depressed? You just might have adrenal fatigue. In this article, I will explain the term ‘adrenal fatigue’ and how you can restore the function of your adrenal and feel great again.


Did any of your doctors ever mention or ask you about your adrenals? Your adrenals are among the most important glands or organs you have in your body, yet most doctors will ask about, talk about, or check their function only when you complain of these symptoms that I mentioned above. From years of clinical experience, adrenal problems exist in eight out of ten patients that complain of fatigue or pain. So, what do the adrenals do and why are they so important?


The most powerful anti-inflammatory glands


Your adrenals are very important for the creation of several hormones, such as testosterone and adrenaline, which keeps you awake and alert. One of the most important hormones that the adrenals secrete is cortisol, also called the ‘stress hormone.’ Cortisol is secreted by your adrenal as response to stress. (1) An increase in your stress levels might lead to an increase in your levels of cortisol. A study that examined the effect of stress on cortisol found that nurses had almost double the amount of cortisol during a stressful day at work (638.1 ng/mL) in comparison to a day off (354.1 ng/mL). (2)


What cause adrenal fatigue?


Adrenal fatigue can be caused by several factors. The most common reason is chronic stress that leads to constant activation of the adrenals. This could be physical stress, such as an injury, falling down the stairs or a motor vehicle accident. It could also be emotional stress due to a ‘toxic’ or abusive relationship, emotional trauma, or a stressful job. Each time you are stressed your adrenals secrete cortisol, a powerful anti-inflammatory substance. [1] Ever heard of somebody that complains to their doctor of chronic pain and gets a cortisone injection? Why are cortisone injections among the most common injections? Because cortisone is very important to reduce and even shut down inflammation. Unfortunately, most injections do not work for the long run and some do not work at all. They also have negative side effects. Your body has its own cortisol making machine. The adrenals! Chronic pain, in most cases, is caused by inflammation and it is the role of your adrenals to secret cortisol and stop the inflammation. In other words, without inflammation, you would not have pain! Sounds simple right? It is more simple than you think. That’s exactly how I got rid of years of back pain and how one of our patients, Dana, experienced a significant reduction in her back pain and complete resolution of her wrist pain only after two months of adrenal treatment.



A case of chronic pain and Adrenals


Dana was referred to us by one of the patients in our wellness programs. She reported chronic pain in her lower back for several years and pain in her wrist joint that started a few weeks before her appointment. She tried medication, chiropractic, and acupuncture several times. When I asked, she said, “I felt a bit better after chiropractic and acupuncture, but the pain kept coming back.” The pain was starting to slow her down and often causing her to be impatient or moody with her children or husband. She described her concerns about the future and mentioned, “I got used to living with the lower back pain, but I am afraid that if it gets worse I won’t be able to spend time with my family or lose my job.” That is a concern that I can identify with. I experienced lower back when I was younger and I know how it can affect every aspect of your life, including your sleep, job, mood, and relationship. We started the evaluation with Dana and found that her adrenals were functioning less than they should. I call it sub-clinical hypoadrenalism, which is a state of under-performing adrenals. The decline, however, is not strong enough to be considered as Addison's disease. How did we test her adrenals?How did we test her adrenals?


Testing your adrenals is simple. However, to get an accurate result you have to do the complete panel and I will explain why. To measure the function of your adrenals, we measure the levels of the hormone it secretes, cortisol. Since adrenal function changes during the day, your cortisol levels change as well. Remember, cortisol does not only reduce inflammation. It also elevates and balances your sugar levels, which causes you to feel awake and energetic. If you have less cortisol during the morning or afternoon, your energy levels will drop and you might feel tired physically or mentally. If your adrenals are working less than they should, your cortisol levels will be lower than they should. With lower cortisol, what will happen to inflammation in your lower back, neck, shoulder, or knees? You guessed it! Without healthy cortisol levels, there will be nothing to stop your inflammation and you will be experiencing chronic pain. Like Dana, you might take drugs for pain, go to the chiropractor, or to see your acupuncturist. However, without addressing your adrenals, the relief will be temporary, and your pain will return. Sometimes it might develop in other parts of your body.     


Treatment of Adrenal Fatigue


Using the RIGHT protocol is key in restoring adrenal health. We addressed Dana’s pain and inflammation by using pharmaceutical grade supplements to support the adrenals and pure herbal medicine to stimulate the function of her adrenal. This has to be done according to the results of the adrenal test. We supported her adrenals in the morning and night time and stimulated it when the test results showed a decline in cortisol levels and adrenal function. The results, a significant reduction in her back pain and a complete resolution of her wrist pain. She was very happy with the results and continued care until the back pain was completely gone.


How do I know if I have adrenal fatigue?


The best way is to test the cortisol levels, at least 4 times a day, for a whole day. In some cases, we will also order measurement of your DHEA levels, since it could be an important hormone in determining adrenal function. There are also a few symptoms of adrenal fatigue. Here are the five main symptoms that might indicate that your adrenals are not working well.

  1. Chronic Inflammation and pain – Studies found that patients with higher levels of inflammatory markers, Tumor Necrosis Factor (TNF-a) and interleukin 6 (IL-6) had lower levels of cortisol in the morning than healthy patients. (3)

  2. You have chronic lower back pain. Your family doctor might have told you that nothing is wrong with your back. Maybe an orthopedic specialist told you that you have degenerative changes or bulging discs and need surgery. Some of our patients were seeing a chiropractor or physical therapist for months and still had pain. In any case, if you had lower back pain for more than 3 months, you probably have adrenal fatigue that is allowing the inflammation and pain in your back to continue. Sometimes, the same applies to shoulders or knee pain.

  3. You feel tired in the morning. Cortisol also elevates your sugar levels to keep you awake. Lowered function of the adrenal glands will lead to low cortisol and lower sugar levels in your blood. The result is feeling tired, unmotivated, and perhaps even brain fog.

  4. You experience anxiety. Your adrenals are also called the ‘stress glands.’ We found that your ability to deal with any type of stress, physically or emotional, is dependent on your adrenal health.

  5. Low sugar levels. Low adrenal function often leads to low levels of cortisol, which leads to lower levels of sugar and fatigue. This is why you might have craving for coffee or sugar in the afternoons.

  6. Dizziness when you stand up quickly. Adrenals has a key role in balancing your blood pressure in your blood. If you feel dizziness sometimes when you stand up quickly, it is very likely that you have adrenal fatigue and your adrenals cannot increase your blood pressure fast enough.  The result, your brain does not get enough supply of blood and you get dizziness.

  7. Sleep issues. If you wake up at night or find it difficult to fall asleep, it is possible that your adrenal is ‘pumping’ cortisol or adrenaline at night time, keeping you awake or waking you up. Sleep is very important for adrenal health and unfortunately, lack of proper and healthy sleep will slowly lead to adrenal deficiency.

  8. Chronic fatigue. Studies show that patients with chronic fatigue had significant lower levels of cortisol in the evening, as well as lower levels of cortisol over 24 hours, when compared to normal and healthy people. Patients with chronic fatigue also had elevated levels of Adreno-corticotropic (ACTH) hormone in the evenings, which is the hormone that stimulates the adrenals to work. In other words, the study found that the adrenals were not responding to stimulation from the brain in the evenings, which indicates adrenal dysfunction or weakness. (4)

  9. Craving salt or salty food. The adrenal regulates blood pressure. Is some individuals, when the adrenal is fatigued, blood pressure might be lower. Since salt or salty food helps increase blood pressure, you might feel craving for salty food as an attempt of the body to increase blood pressure. If you are craving salty chips, potatoes, bagels, or other salty foods, you might have adrenal fatigue.

  10. Feeling depressed or moody. Studies show that in adults, abnormal levels of cortisol are associated with depression, while in children elevated levels of cortisol are associated with sensation of anxiety. (5, 6)


Q & A


Why didn’t my doctor talked to me about adrenals when I described my pain?


Adrenal Fatigue, also called subclinical hypoadrenalism, is a medical condition that is not yet recognized by mainstream institutions. According to mainstream medicine, the adrenals do not have a lower state of function, such as the heart (chronic heart failure) or the kidneys (chronic kidney failure). Therefore, most doctors will not test or they will ignore a condition in which you might have lower function of your adrenal, even if it could be measured as low cortisol. In functional medicine we believe that the function of each organ can change according to the factors that simulate recovery or health or factors that inhibit, weaken, or damage an organ.


In my opinion, there are several reasons why the medical community do not recognize adrenal fatigue. The first reason is because most doctors have not learned about the connection between adrenal and pain or inflammation in medical school. The second is because conventional medicine is a medicine that is based on pharmaceutical or surgical solutions. Since there is no pharmaceutical solution that actually treats the adrenal, your doctor probably never learned about it. The last reason is when it comes to chronic conditions, medicine has become a symptom management practice rather than finding and treating the root cause of your problem. That is what functional medicine doctors do the best. In most chronic conditions, your doctor will give you a pill to stabilize the condition, but will not resolve it. For more information, call us at (503) 545-6285.


How do I treat my adrenals?


It is possible for you to do some work on your adrenals. Before you do, let me ask you a question: If your fridge or car breaks down, will you try to fix it yourself? You might research solutions on how to fix your car or fridge. However, if you are like me and do not have the training and experience to fix a fridge or a car, I recommend calling a professional and get it done in the most effective way possible. Fixing your adrenal is not much different. Your adrenals are a complex organs, which function as part of a bigger system, the hormonal system. For that reason and others, I recommend finding a professional that can test you, build a custom protocol that fits you, and guides you through the process to get the results you want. For more information, call our team at (503) 545-6285



  1. The effect of a hormone of the adrenal cortex (17-hydroxy-11-dehydrocorticosterone; compound E) and of pituitary adrenocorticotropic hormone on rheumatoid arthritis. Hench PS, Kendall EC, Proc Staff Meet Mayo Clin. 1949 Apr 13; 24(8):181-97.

  2. Pires da Rocha, M. C., Figueiredo de Martino, M. M., Grassi-Kassisse, D. M., & Luiz de Souza, A. (2013). [Stress among nurses: an examination of salivary cortisol levels on work and day off]. Revista Da Escola De Enfermagem Da U S P, 47(5), 1194-1201. doi:10.1590/S0080-623420130000500025

  3. DeSantis, A. S., DiezRoux, A. V., Hajat, A., Aiello, A. E., Golden, S. H., Jenny, N. S., & ... Shea, S. (2012). Associations of salivary cortisol levels with inflammatory markers: the Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology, 37(7), 1009-1018. doi:10.1016/j.psyneuen.2011.11.009

  4. Demitrack, M. A., Dale, J. K., Straus, S. E., Laue, L., Listwak, S. J., Kruesi, M. J., & ... Gold, P. W. (1991). Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. The Journal Of Clinical Endocrinology And Metabolism, 73(6), 1224-1234.

  5. Reddy, S. P., Prasad, M. G., RadhaKrishna, A. N., Saujanya, K., Raviteja, N. K., & Deepthi, B. (2017). Correlation between salivary cortisol levels and dental anxiety in children of smokers and nonsmokers. European Journal Of Dentistry, 11(2), 192-195. doi:10.4103/ejd.ejd_171_16

  6. Vasiliadis, H., Forget, H., & Préville, M. (2013). The association between self-reported daily hassles and cortisol levels in depression and anxiety in community living older adults. International Journal Of Geriatric Psychiatry, 28(10), 991-997. doi:10.1002/gps.3912


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