Adrenal Fatigue Recovery (Am I on the Right Track?)

By: Michael Lam, MD, MPH; Carrie Lam, MD

Approaching Adrenal Fatigue Recovery

Adrenal fatigue recovery is a processThe speed of Adrenal Fatigue recovery varies greatly from person to person. Under expert guidance, the process normally takes a few weeks in mild cases to a few months in moderate cases. In severe cases, much longer time might be needed.

Many people question whether a total and complete Adrenal Fatigue recovery is possible. The answer is yes in the vast majority of cases, but only if done right. Adrenal Fatigue Syndrome often takes a decade or more to develop. It is important to allow the body time to recover. A few months of recovery is considered a short time within this time horizon. Time is a great healer when the body is given the proper nutrients along with proper lifestyle and dietary protocols. Those who demand a quick Adrenal Fatigue recovery invariably become disappointed because the body is not a light switch that can be turned on and off at will. A systematic and logical approach works the best under professional guidance.

The Adrenal Fatigue recovery curve is a graphical representation of how the body recovers on the vertical axis plotted against time on the horizontal axis. A good recovery curve usually consists of multiple mini-cycles. Each cycle has three sequential periods, resembling an “S” curve that last from 1-6 months each. The overall successful Adrenal Fatigue recovery plan consists of multiple “S” curves in an upward sustained series without allowing any major downward crashes. Over time, this will resemble a series of stair-steps upwards, as illustrated in the graph below.

A typical Adrenal Fatigue recovery curve

Let us look at this cycle in more detail. The overall Adrenal Fatigue recovery curve is composed of multiple mini-cycles. Each mini-cycle consist of three periods:

  • Preparation Period. This period normally lasts from 1 day to 6 weeks, depends on the stage of adrenal fatigue. The stronger the adrenal function, the shorter the duration. During this time, the body normally may not feel any significant difference even though nutrients have been administered. One continues to feel fatigue. This is the period where the body builds its lost reserve and internally gets stronger. It is not uncommon to feel even worse from time to time. Paradoxical reactions may arise during this time and adjustments of nutrients may be needed. The body may be in a process of resetting itself internally. Supporting the body may involve increasing or decreasing the dose of nutrients, depending on the body type and sensitivity level. Strategies that do not allow the body to go through this important preparation stage often fail over time, as the body simply does not have the reserve it normally needs to cushion itself against stressful time that is unavoidable during any recovery process. Small dips within the Adrenal Fatigue recovery cycle will then occur. It is like forcing an athlete to run a sprint without adequate warm up.
  • Honeymoon Period. This usually follows immediately after the preparation period and can last a few days to 12 weeks if the preparation period is carried out properly. Again, the duration is highly dependent on the stage of adrenal fatigue. Generally speaking, the earlier the adrenal fatigue stage, the longer this period can last. The weaker the adrenals, the more tendency for this period to be short-lived unless under professional guidance. During this time the body is able to handle stress better. Fatigue reduces, palpitation frequently dissipates, and anxiety attack diminishes. Blood pressure starts to stabilize, brain fog starts to dissipate, and functional sleep returns. There might be mini-crashes and setbacks from time to time that last a few days. They are more tolerable compared to before, but recovery is faster. There is an overall sense of well being as if a burden has been lifted from one’s shoulder. An overall sense of optimism returns. Those having frequent infections will find that recovery is faster, and frequency of infection is reduced. By the end of this period, many troublesome symptoms should have greatly reduced. There should be sustained energy to carry out normal daily activities, and social activities returns. If there is concurrent thyroid illness, many will note the returning thyroid function and that less medications are required. Any female hormonal imbalance such as PMS is reduced and menstrual cycles become more regular.
  • Plateau Period. The body is stabilized. There is no set time frame for the duration of this period. Generally, it lasts a few weeks to a few months. In early stages of adrenal fatigue, this period can go on for years and totally asymptomatic. In later stages of adrenal fatigue, the picture is much more dismal. Sufferers have to slowly adapt to an overall lower level of energy function. Overtime, they have forgotten what it feels like to be in optimum health and indeed often have given up, especially if adrenal function during this plateau phase is below the adrenal symptoms threshold level, where they are constantly suffering. In other words, here “you learn to live with what you have, even though you are not comfortable”. If the adrenal function is already at its maximum, one can be stuck at this period for a very long time without upward progress. Many on self-guided programs would not be able rise to the next cycle due to the lack of foresight and planning. This is perhaps the most trying time, as impatience sets in. Most interpret the lack of continuity and sustained improvement as failure and become disappointed. Thus, additional stress can be put on the adrenals unknowingly. Others might start to take more nutrients, thinking that it will help speed up the process and forcing the adrenals to work harder at a time when it is not capable of doing just that. Forcing the body to accelerate instead of allowing it time to rebuild itself is a grave mistake and often leads to unexpected and severe crashes at the end. An experienced clinician will use this time smartly to allow the body to rest, yet slowly transition the body using proper nutrients to get ready to go to the next preparation of the full Adrenal Fatigue recovery program. Sad to say but what inevitably follows this phase is another crash for most people unless they are professionally managed by experienced clinician. This is especially true in advanced cases of Adrenal Fatigue (stages 3 and 4).

As a person goes through multiple successful mini-cycles without major setbacks, the overall sense of well-being gets better with each cycle. Though the most dramatic improvement often comes in the first few cycles, one accumulates more energy with time, and fatigue becomes less pronounced. Any setbacks between the cycles are often less severe as the previous crashes. One archives a higher high and a higher low in terms of well-being with time. This is recovery at its best. The body is allowed to rest after each upward movement. It has time to build up reserve before ascending again. This reserve building time is critical. Proper nutrients administered here strengthen the adrenals and cushions the mini-crashes and setbacks so frequently experienced by all. Having enough reserve allows the body to continue its rebuilding process on a sustained basis while withstanding insults from daily life.

Most people have a mistaken belief that the hallmark of a successful Adrenal Fatigue recovery program has an early onset of increased energy and fatigue removal. They expect this to be sustained on a linear basis uninterrupted in an upward trend line. This ideal situation only occurs in a minority of cases where the fatigue is very mild and under expert guidance. For most cases, due to internal derangement of the adrenals, the road to recovery is laden with pot holes and crashes.

Most self-guided programs achieve success in ascending the first cycle. Those who take stimulatory nutrients often experience an initial sense of well-being, followed by a prolonged plateau that is unable to ascend further. We call this “hitting the wall”. Regardless of what nutrients are given, the body fails to gain more energy. Fatigue continues, as illustrated in the graph below in line A

Overtime, the body starts to decompensate, and with a stressful event, a crash is triggered and the Adrenal Fatigue recovery process goes backwards down a few steps. The body returns to a function worse than before. It then stabilizes for a while, but is unable to regain its composure. Extraordinary effort is needed to gain a small incremental sense of well-being. With each succeeding stress, the body decompensate further. Stressors can be physical such as excessive exercise, emotional such as mental strain, or nutritional such as taking more nutrients that are thought to be good but cannot be processed or assimilated. The overall recovery curve resembles that of a stair step going down, with lower lows and lower highs as illustrated in line B.

Some abnormal Adrenal Fatigue recovery curves

Those whose bodies are constitutionally sensitive may not even experience the initial onset of energy. They crash right from the beginning and never fully recover from it, as illustrated in line C.

© Copyright 2016 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

A person develops AFS usually is because of lifestyle and personality. Some people are genetically prone. If they learn what cause them to have AFS and learn to manage them well, then AFS should not recur. For overall health purpose, it is always good to take some supplements because the food nowadays does not have as abundant nutrients as they used to be.

Adrenal fatigue recovery is a process
5 - "Dear Dr Lam,"
Dear Dr Lam,

First and foremost, THANK YOU! Time and time again, I have come back to your website that I first found through Google. Then I was given copies of it by a hormone specialist I went to see. I also share it regularly with others that I encounter who seem to be challenged by this vague, hard to diagnose, and unrecognized by mainstream western medicine medical challenge. Your information is a source I repeatedly go back to. More recently, I noticed some significant updates. All of it looks great. Thank you!


  • Marian says:

    I’m a 36 yo female, with low cortisol levels. I’ve been to many doctors and naturists, I started treatments a year ago. I know have developed fibromyalgia. I’m taking adrenal health (Gaia). Is that supplement recommended for state 3 when cortisol is low?
    Thank you,

  • Jacob says:

    Do some people never fully recover from a crash ever?

  • Fatima says:

    Wonderful. I knew that Adrenal Fatigue recovery could take some time, but having the steps explained was really helpful and gives some hope of what to expect.

  • Kimberly says:

    Can people recover completely in less than a few months if they are in early stages?

    • Dr.Lam says:

      Yes, especially when they are young and under the right program. The key is to do it right. Sometimes it may appear to have recovered but the underlying problem remains and that is most dangerous as it can trigger relapses.

      Dr. Lam

  • Lynn says:

    During the honeymoon phase is it possible to crash and have to start over?

  • Berto says:

    Thanks for posting this article. Ive just taken stabs in the dark with my issue. This clears us a few things.

  • Jenny says:

    If you are in earlier stages, how do you know if you are progressing since symptoms seem to yoyo?

  • Missy says:

    Is it normal for the cycle (Preparation, Honeymoon, Plateau) to repeat itself or does one usually end and stay at the Plateau stage?

  • Andrea says:

    Dr Lam,
    I was diagnosed with Lyme disease (chronic).So if my adrenals where healthy I would not have suffered from the disease? I have breathlessness from just lifting or going up stairs..could this be caused by adrenal fatigue? What is the best supplement in your opinion for adrenals? Thank you your articles have been very enlightening.

    • Dr.Lam says:

      Chronic Lyme is very complex. It can wear down even the strongest adrenals over time. Breathlessness is more of an adrenal issue and you should be concerned. Click Adrenal Exhaustion for more information.


  • William E. Parks says:

    Dear Dr. Lam, After much encouragement from my cousin who is a DVM, I decided to clean up my diet. On Jun.23 2016 I completely cut out all chemicals from my diet. With in about 2 weeks I began to feel better than I can ever remember in my 56 years. I began to have so much energy that for the next 6 weeks or so I worked harder than I did at 20, I also found myself under so terrible stressful situations, with my teenage son, tenants, and other business’ that I own. Long story short, I hit the wall.- Lost all energy, depression cam back, knees ached, hair fell out etc; so discouraging. I am still on my clean food diet and have tried to control my stress. – After about 4 months I feel like I’m starting to improve some, but still have some pretty bad days. – Can you give me any words of encouragement? — Also from what I understand from your article, you are not a big fan of supplements? – Thanks in advance for any advice you may be will to share.
    W Parks

    • Dr.Lam says:

      Relapses such as what you experieinced is quite common, and it reflect incomplete healing or insufficient reserve at the core level deep down. that is why when the body calls for support, it is not quite there. supplements has to be properly done to be effective long term as it can mask the underlying problem. The problem with AFS is that most people tend to go thru what you went thru. it will continue to happen even if you recover this time. The good news is that it can often be reversed, but because each person is different, there is no way to give you a one size fit all. you can call my office and ask for a telephone appointment and I will go thru with you your options.

      Dr Lam

  • Chad says:

    Hi Dr. Lam. I’ve been following advice from my doc and it seems to help with my energy, but sometimes I get tons of nervous energy. Is this a sign that I’m about to crash again?

  • Brooke says:

    After the honeymoon phase is it possible to crash even harder?

  • Holly says:

    This is fascinating, because it makes sense because the body fluctuates and adapts. Thank you for explaining this so well for me!

  • Jerry C says:

    Dr. Lam, how does one recognize a paradoxical reaction from a herxheimer reaction?

    • Dr.Lam says:

      A herxheimer reaction is due to over zealous detoxification ( such as enema, flushes, fasting etc ) beyond what the body can handle. Paradoxical reaction happens at normal dose of drugs or natural compounds that is unrelated to any detox process.

      Dr Lam

  • Marissa DelGodo says:

    Hi Dr. Lam,
    Thank you for providing this valuable information. I have been working with a natural path and a Dr. Of Osteopathy that practices an evidence based approach with integrative medicine. My saliva cortisol tests came back with my cortisol levels extremely low throughout the day and out of range. My progesterone and estrogen are both high and my testosterone is low. At night (especially between 2-4 a.m.) I wake up “wired” with heart palpitations and have difficulty falling back asleep. My guess is that adrenaline is being pumped out to compensate for such low cortisol levels. I have tried supplements such as Seriphos and Cortisol Manager (on the advice of a natural path doctor) but I fear that they are only lowering my levels , causing these spikes at night. When I tried Ashwagandha I felt so low and horrible the next day. Do you think Rhodiola will help as an adaptagen? What else can I do to fix this? I am also supplementing with Vitamins C, D and Panthoneic Acid. All of this came on after a very traumatic postpartum experience and has lasted for over 8 months now since the birth of my son. Thank you for your time.

  • Alberto says:

    Is there any product or technique to stop a crash in progress? Like a rescue inhaler for an asthma attack?

  • Jane says:

    How do I go about finding a doctor in my area that understands adrenal fatigue and can help me without going to several doctors and getting no where. which is what I have been doing

  • Aerol says:

    How can I tell if my protocol is making progress, what subtle signs should I look out for, if any? What area of improvement do you typically see first?

  • Caesar says:

    If a person starts experiencing an abnormal recovery curve, will the curve ever normalize enough for them to start feeling improvement?

  • Danielle says:

    my osteopathic physician diagnosed me with adrenal fatigue. It took almost 2 years to heal. I was hesitant to take supplements she recommended in the beginning, but finally did. I think I took them regularly for one year. Last Nov.2015, I quit taking AdrenoMend, Ashwaganda, DHEA, St. Johns Wort. I had no side effects at all from stopping and never felt any dependancy. However, in May (6 months off) I started with fatigue and now its Sept and I realize Im back to Stage 2, almost Stage 3. I have almost every symptom, the worst has been anxiety and panic attacks. Stress is a factor at this time. I have just started taking AdrenoMend by Douglas Laboratories again, and an Organic Ashwaganda Root, and St. Johns Wort by Gaia. There is so much information on your website and its going to take me a while to go through. Im desperate to feel as great as I did end of last year. I understand you may not be able to advise me, but some encouragement that maybe Im going in the right direction or should I reevaluate what Im doing. Is Douglas Labs one that you think is bad? My body did well with it before.

  • Rudy says:

    Hello Dr Lam,

    Would you advise me taking Dhea 25 to treat my adrenal fatigue?
    Yes/no? And why please.

  • Jaclyn says:

    I experience the traditional upward “s” curve you explain but it seems when i do crash each crash feels worse and more intense than the last . what do you reccomend?

  • T. says:

    Thank you for your time and reply. No family history. Since there is an adrenal component to insulin levels, wouldn’t adrenal support help improve the AIC along with avoiding carbs and exercising?

    • Dr.Lam says:

      Supporting the adrenals are helpful in optimizing metabolic balance. I have an entire book on this. Click Book – Advanced Symptoms Adrenal Fatigue Syndrome – A Metabolic Perspective for more information.

      Dr Lam

    • Alison Steinlage says:

      Just wondering if you’ve retested your A1C after treating your adrenals and avoiding carbs? I also have this problem and have been watching my diet very closely, taking cortisol lowering supplements and walking 30 minutes everyday. I am going to retest in early July hoping for good results. I see this was posted in September……have you had improvement?

  • T. says:

    Thank you for the title of this article, it is very important to have hope of recovery and to see signs of improvement. I started to add proline to my buffered vitamin c and I am having improved symptoms. Thank you. Now I want to continue in the right direction. That’s the enormous challenge though. Just starting menopause, long standing hypothyroid and now…A1C is prediabetic. Which directions, articles and supplement resources are available to me at this time since my frequent urination has just about stopped with the addition of proline 4x day? Also I want to reverse my A1C and after many months of effort and changes not yet.
    I am slightly encouraged since I had a positive effect in a short time with adding the proline. Thank you for your consideration, time and resources.

    • Dr.Lam says:

      For A1c, you need to see your primary care doctor. Avoiding carbs is the best way, but depending on what else is going on, other matters may have to be addressed, especially if you have a family history of diabetes.

      Dr Lam

  • Ramy says:

    Dr Lam,
    I have frequent adrenal crashes (none of the doctors used that term even after explaining them what I am going through from 2 years) It’s like something is drained out of my body when I am not able to handle stress very well.Its like a switch has been put off and I go on safe mode(just like your webpage says).After the crash it takes minimum 7 days to recover to the point where I can atleast start functioning. Then bam not even a week passes and it hits me again and I am back to square one.
    One thing I should mention that I am so scared of that failure that I always be in alert mode making sure I don’t do anything which can trigger the clash again ,I always fail.It feels like whatever is trying to recover in my body is not able to because if such frequent setbacks.My setbacks are as frequent as 10 days max.
    My doctor says it’s a psychological problem and suggesting me to go on SSRI.
    I am from India and finding the right practitioner is almost impossible for me.
    I would be very grateful if you can try to analyse my situation and suggest me what to do.
    My question is – is it possible my thoughts are targeting the crashes? Because it always happens when I reanalyze something and my brain says I have not done something in a proper manner?
    I should also mention I took Paxil .25 for a month and I suffered 2 crashes but instantly recovered ,like in one day.I stopped it because I don’t want to go on meds.But I will if that’s the only solution.
    How can my body recover when I get these crashes so frequently that whatever is damaged isn’t even fully recovered and I get another crash?Can it be ocd?
    Please help.
    If someone can relate to my situation then please comment.
    Thank you very much.

    • Dr.Lam says:

      Your thoughts can affect the hormonal axis and trigger crashes. If you are continually relapsing , you will tend to get weaker with time and ultiamtely bedridden if not reversed. This is not a time for self navigation. Find someone who knows what they are doing. What works for one person may make you worse. If you need more information, we do have a telephone coaching service for people like you provided that you qualify. Click Crash & Recovery Cycles for more information.

      Dr Lam

  • Daniela says:

    For someone who is in the plateau period with an overall lower level of energy…does that mean they will be unable to experience any more upward progress?

    • Dr.Lam says:

      Plateauing can have many reasons, from improper program to organ resistance. Depending on the root cause, this is a time for you to evaluate whether you are indeed on the right track. Common mistakes can retard your recovery. Click 7 Adrenal Fatigue Recovery Mistakes for more information.

      Dr Lam

  • Robyn Hope says:

    I want to know if others afflicted with AF have a continuous frog in their throat…hoarseness…frequent clearing of throat.
    Also, I feel that weight loss due to depression should be brought up, as depression is common with AF. So far, one always reads about weight gain, or trouble losing.
    Would appreciate feedback…thanks.

    • Connie says:

      Hello Dr Lam, thank so much for your information, it helps to know I’m not alone. Through an integrative medicine doctor I found that I have AF and previously had CFS. I eliminated all sugar and eating mostly a vegetarian diet. It’s very frustrating as I want to work and excercise but crash after any sort of exertion. Afraid of being able to hold a job as I have my young family to look after also. I have lost weight and muscle and have no strength anymore. Please help with any suggestions as my general pattern now is going 3steps forward and then 5 steps backwards. Thank you once again.

      • Dr.Lam says:

        If you are on the right track, you should be making gradual advance steps. Something therefore may be off. It could be your lifestyle, supplement, or a host of other factors. Loosing weight is not good if you have concurrent AFS. Click Catabolic State & Adrenal Fatigue Syndrome for more information.

        Dr Lam

  • Melody says:

    I have your book and have returned to my good doctor of 16 yrs. After two rounds of saliva tests and 4 months of supplements/diet,but not really taking it easy yet( aide),my almost flat line cortisol levels have not raised themselves. The neurotransmitters have moved a tiny,tiny bit. He says this is stage 4 adrenal exhaustion–very close to bedrest. It is true that I do feel like laying around most of the day. I catch whatever bug is going around at school—-sick about every 3 wks…..time to stay home?….then what do I do with myself? Avoid as much stress and exertion as possible? That is what I feel like doing but can’t imagine it. I’m 62 yrs old and have always worked. What kinds of things can I do day-to-day and not compromise my recovery? Right now he’s thinking 9-18 months of going on disability. A shock,but deep down I know I need to take this very seriously.

    • Dr.Lam says:

      if you are near housebound or bedbound, you need professional guidance. The right doctor is the key because everyone’s requirement is very different and no two person is alike. Resting is good but seldom sufficient because the body is too weak and need some external help. Try to avoid stimulants and steroids if you can. Laboratory test are not very accurate when it comes to this point. Recovery is possible, but it takes a good program. that is the key. Click Laboratory Testing for more information.

      Dr Lam

  • Dennis Christiansen says:

    Hi Dr. Lam
    I am a 26 year old man. 2 years ago I exhausted myself completely with education, work and ironman training. Now I am finally beginning to see an end to it. I haven’t been able to excercise like I used to for a long time, which was very hard for me. Every time I tried to go for a short run or go biking I would sleep even worse than I already did. I’m wondering if it is okay to start excercising lightly now that I feel better even though light symptoms occur after excersise. Also I am wondering if I will ever be able to do highly competitive triathlon again after this period of overtraining and adrenal fatigue.

  • Jason says:

    This is fascinating. Thank you Dr.Lam! why would some people get worse while going through the healed process? Will their dip in health ever recover?

  • Susie says:

    Hi Dr. Lam, I had an adrenal crash a few months ago and just got back results from a recent saliva test showing that my adrenals are functioning pretty well overall now … however, I still feel extremely fatigued and having a hard time being out of bed and walking for more than 10-15 minutes. Is this just deconditioning from bed rest? How long can it take before the body feels better once the adrenals are recovered? I recently started your yoga dvds, so am hoping that might help.

    • Dr.Lam says:

      It is not unusual for your symptoms not to correlate with the test results. It could be lagging, but more often than now, symptoms are usually far ahead of test results and you should really pay more attention to why you are still feeling so fatigue. YOur assumption that just because the lab values are “normalized” means that the adrenal has recovered needs more detailed exploration as it can also mean that there are underlying issues not exposed in the test yet and the test results therefore can be misleading. The DVDs are very powerful. Make sure you go slow from the beginning and do not over strain yourself.

      Dr Lam

  • Adriana says:

    But other factors in life can affect these results I am a single mom and I work 2 jobs so just the stress alon I never feel like I will be able to recover.

  • Charles B. says:

    I am a 56 year old man who has had a cervical fusion,left shoulder replacement both knees replaced at the same time and then wisdom teeth removed and to top it all off I had to have my gall bladder removed.This all within 3 1/2 years.Also during this time we lost our house to some toxic flooring that was installed during my surgery times.I think my body was overly sensitive to the chemicals in the flooring which was on 60 Minutes show along with NBC national news.I’m not going to name the company involved.I became ill feeling as soon as walking in the home and not feeling better until getting in fresh air.We repaired the home and sold it for what was owed on it.I lost 15 years of mortgage payments.On top of all that myself,my wife,my daugther four cats and a dog had to move in with my elderly parents until a home was delivered and set up.My dog came down with cancer which I’m sure was do to the flooring,also we had a cat to die without the vets being able to find a problem.another one was having seizures during the time we were living in our old home.Since moving the cat hasn’t had anymore seizures but I’ve had to spend over 6 thousand dollars on our beloved dog,whom i love more than myself. During the knee replacement surgery I didn’t sleep for almost a solid week except short 15 min naps at best.i picked the wrong rehab center to go for after care and while there I developed celluitis and my kidneys failed.I wound up back in the hospital.About 1 year ago right after my gallbladder surgery my eyesight got bad and I had some kind of panic attack.something that has never happened to me before.also my digestive system shut down. I think my adrenals finally failed.I also think I went into a Catabolic state for about 2 months.Lost 50 lbs,at least 25 lbs of muscle.I get the same story from all my doctors,It’s just stress,your blood work looks within range. Just on testosterone gel every day. I’m on my third week of NT Factor and feel somewhat better but taking supplements more than once a week seems to make my condition go in reverse. I drink tons of water and eat only certain foods,mostly vegetarian ,some of those foods make me feel worse.I used to be able to work 56 to 60 hrs a I can hardly work for an hour doing light work which is better than I could do 6 months ago.If I over do it,the next day I have to stay in the house and rest.One more thing the first 6 months I couldn’t sleep more than three hrs per night.I was wired and exhausted all the time.Along with eyesight coming and going at different levels from day to day. I have never been so uncomfortable in my entire life.I would rather deal with the pain I was in before all those surgeries. My primary care doctor says I’m stuck in the fight or flight mode. I am getting better very slowly but not fast enough.Life is passing me by. One other thing that makes it worse ,people look at you as though your lying or crazy when you tell them whats wrong. All I can say is this is pure Hell.I feel for anyone who is going through this stuff or has gone through it.

  • Becky says:

    Hi Dr. Lam

    I am a 46 yo female who has been hypothyroid for about 23 years, taking levothyroxine. My numbers are normal but have recently switched to Armour to see if that will help some of my symptoms. I have been surgically post menopausal for 3 years, taking monthly estrogen shots. I work full time, have a disabled son and husband. I have told I have pyroluria but cannot tolerate the supplements (zinc and B6). I have recently withdrawn from Cymbalta (in 2012) and Klonipin (last dose Feb, 2016). I am having so many symptoms and don’t know what to do. I am orthostatic, although drinking plenty, I am constantly cold, I am irritable, fatigued, my hands always feel freezing, I have cramping abdominal pain and I have lost probably about 5% of my weight in 3 weeks (unintentional). I went a week or two where I could eat almost nothing but am able to force myself the last few days. I had adrenal testing in 2015 which showed nothing. I recently had saliva cortisol which showed normal except an elevated around 11 am. I’ve been to ER twice in 2 weeks, all “typical” labs normal. I am forcing myself to take walks twice a day (before and after work) but can’t do much more then that. I don’t know what to do now …. Frightened

    • Dr.Lam says:

      what you experienced is actually quite common, and it reflects that your current approach may not be what your body really wants. The fact that you cannot tolerate zinc and B6 as an obvious solution to pyroluria is your body’s sign that the right thing done at the wrong time may backfire on you. Click Pyroluria & Adrenal Fatigue Syndrome for more information. When AFS is present, many pathways do not behave normally, and unless your practitioner factor in these , the “standard” approaches actually can make you worse. The harder you try, the worse you get. I cannot go into the specifics because its the overall concept you have to get first. I urge you to go back to your practitioner and seek new directions, or as last resort, call my office.

      Dr Lam

  • Chris says:

    You’re the best Dr Lam!

    So Im 28, feel like im finally recovering after being bed ridden for half the day months ago (I have a good ND 😉 )

    Quick question.. If you’re in say stage 3, when u start recovering will u go back to stage 2, then stage 1, then be normal.. Does it go reverse like that with the symptoms when recovering?

    • Dr.Lam says:

      Ideally, you revers and go to stage 2 and than stage 1. Young people do recover quicky, but they also have a tendency to relapse quickly, especially if you are dependent on glandulars and herbs to feel good. Be careful. Click Adrenal Fatigue Glandular & Herbal Therapy for more information.

      Dr Lam

  • Jennifer says:

    Even if constitutionally sensitive, is it possible to fully recover?

    • Dr.Lam says:

      It all depends on the degree of weakness as well as what is being done and the degree of damage. The body does have tremendous ability to self heal as the mechanism is in place. Some people do better than others. The weaker your consitution, the more fragile the body and the more careful you have to be. Most self navigation effort fail because of not having enough clinical experience to support the body when it is in a weakened state, resulting in worsening condition, sad to say.

      Dr Lam

  • Kzev says:

    I am only 18 and have been diagnosed with CFS / fibromyalgia / and adrenal fatigue . is CFS and adrenal fatigue really the same thing ? My biggest symptom. Is air hunger and breathing due to autotomic dysfunction . I was a high school soccer player and probably over exercised among with having constant sinus and upper respiratory infections . My onset was sudden and now I am trying to treat and heal . My T3 thyroid is low and I now also have vey blocked nasal passages . I am resting and taking supplements along with neuromuscular massage but not seeing as much progress as I would like to see. I would love to exercise but do not have the energy and I feel I cannot take a deep enough breath to intense activity ? I was a vey active heathy athletic teenager before this happened . My parents and I cannot figure out how or why this happened . I am trying to go away to college in the fall but I have to get better . It seems if I do too much activity then I have a set back and feel worse for days . Can you give some guidance ?

    • Dr.Lam says:

      You are too young to be in such a problem. Dysautonomia is quite serious and a sign of late stage AFS. You need to take some time and really help the body heal properly over time and it will not be a fast track as not possible. The right comprehensive program can help, but everyone is very very different. What works for one may worsen another. Our telephone coaching program deal with this. Give us a call if you dont find someone to help you. Try not to go on medicine as once you start, its hard to come on.

      Dr Lam

      • Kzev says:

        Thank you for the reply I am taking supplements vitaminC , fish oil , adrenal cortex , an antiviral for Epstein Barr and then just stern 5mg hydrocortisone once a day. I know this is nit recommended but integrative health professional prescribed die to length of condition . They also prescribed florinef for pots symptoms for low blood volume but I did not take as I feel it is not needed. I am resting , changed my diet no dairy or eggs and eliminated stress as much as possible . I hope I can begin to heal . Any guidance is welcome as the worst symptom is the breathing and air hunger . Thank you

        • Dr.Lam says:

          You are being put on “heavy guns”, and they could be indicated at the right time and circumstances. Continue to follow your doctor’s advise is best as each case is different. The problem with steriods is once started, it is very hard to come off. So be careful.

          Dr Lam

    • Kathryn says:

      I’ve had CFS as well as adrenal fatigue for much of my life and I found out that, if I’d known what caused it when I was young like you are, it would’ve changed my life. I had chronic viral relapses for several years and, later when I was older, I discovered through a naturopath that I had chronic candida overgrowth in my gut and, if I had known how to reverse it before it went on too long, I could’ve become much healthier and never developed both leaky gut syndrome (google it) and adrenal fatigue. I reversed my CFS by taking massive doses of probiotics, starting with 2-3 billion a day to control die-off symptoms (google it) and working up to 150 billion daily until my immunity recovered. After I didn’t safeguard my diet enough later and didn’t keep taking probiotics, I had another case of CFS because I had a lot of damage in my gut from the earlier period of CFS and knew I had to change everything but didn’t know that I could’ve ever drink tequila or alcohol and, after that, I got CFS again, this time I took the same amount of probiotics and recovered again, but I was left with burnt-out adrenals from the illness and now I’ve got fairly severe adrenal fatigue which I’m recovering from slowly.

      The difference between CFS and Adrenal Fatigue (AFS) is that CFS is often caused by candidiasis and adrenal fatigue is the result of too much infection for too long, taking its toll on the adrenals, which also causes some of the same symptoms. I hope this makes it clear that, even though you’ve got some work ahead of you to recover, if you address both chronic candidiasis and adrenal fatigue, you’ll get better, but the candidiasis is a very important part of the problem. If you ever took a lot of antibiotics which kill probiotic activity in the gut and depress your immunity, then it would explain why you got CFS to begin with (or a very sugary diet can contribute as well). But please know that, even though your doctor will treat your symptoms, the most important thing you can do, with the help of your parents, is get a professional that understands and tests for candida overgrowth so you can begin to reverse the CFS and then stay strong so your adrenals can recover. You’re young and resilient and you can do it! Take care, Kathryn

  • Angie says:

    Thank you Dr. Lam for your wonderful articles I am greatly enjoying learning more in depth the affect of Adrenal Fatigue on the body and how to find my way to recovery in light of “normal” test results and the slew of doctors without an answer to my concerns.

  • Chavy says:

    Thank you so much for all this information. I havent found such great info anywhere on the web.
    I am 28 and i have experienced what i believe to be adrenal crashes several times in the past 3-4 years. I followed naturopath’s diet & supplements. Slowly i regained energy but i find that any severe stressors or lack of sleep plunge me right back to the bottom.
    Right now i think im in a very low. Extremely thirsty, dry mouth, eyes, skin. Urinating very frequently, drinking doesnt help cuz it goes right out in the urine. I wake up feeling as if i have fasted for several days. All shakey, irritable, brain fog. It also causes me to have frequent bowel movements.
    I understand the entire process what happens to the body, according to what you explained. I just dont know how, and what to do to recover. Im in bed, cant move a limb. Muscles burn…
    Can you share some directions for me what to do & how to rehydrate my body?
    Thanks for everything, may you be blessed with great health & wealth, & may you continue to help people.

    • Dr.Lam says:

      your current symptoms are worrying and you need to see your doctor for help. Rehydration needs to be carefully done as you can trigger imbalances in electrolytes in the process if the body is fragile. This article will help you understand more. Click Fluid Balance & Adrenal Fatigue Syndrome for more information. Fluid imbalances is only a symptoms. Deeper issues are at stake which need to be resolved well beyond AFS as your symptoms really reflect a dysregulated NEM (neuroendometabolic) response.
      See this article: Click NeuroEndoMetabolic Symptoms of Stress for more information.

    • Kathryn says:

      It’s important, after you check and blood test for sodium through your naturopath, to take the appropriate amount of sodium, often by drinking sodium in water advised by your doctor, to regulate sodium with all the water you’re drinking which isn’t retained with low cortisol and aldosterone levels associated with AFS. I take a heaping teaspoon in the morning in warm water with food and vitamin supplements to counteract the effects of low sodium. Be sure your naturopath checks your sodium level so you can be sure that’s part of the problem. I suspect it might be.

  • Kristi says:

    Aloha Dr. Lam, thank you so much for all your work in this area. I am 49 and have been on this journey for several years. I’m not usually a person who gets sick from anything, so I think that overtime I overlooked certain signs.

    About 4 years ago, I became so exhausted that I could barely leave the couch for a couple of days. I felt like I could hardly raise my arms. I also started having very painful menses with feelings of being very faint. After going to acupuncture for several months, I felt like it got better but was perhaps not as good as I thought.

    Even though I feel better energetically, I keep having symptoms pop up like extreme dry/blurry eyes, hair loss, rosacea, weak limbs, heart palpitations, waking up at night, etc. which I haven’t been able to heal from. Now I am having an extreme problem loosing weight. My body is over sensitive to sugars and starches but feels depleted without them. Over the last few years I have used the HCG diet to help me loose weight. It was the only thing I have found that helped. But now my body is resistant to everything I try to loose weight. I have to practically stave myself just to not gain weight. I recently went to the doctor (I don’t usually go to allopathic doctors, but thought they could run some blood work.) He finally reluctantly agreed and while most everything came back normal, my ANA came back high at 1:640. He then tested for Lupus which came back negative. I have tried an ARRAY of different supplements (including some you recommend) and recently stopped everything because I felt like some of them were competing against one another. I meditate 1-3 times a day, have tried different nutritional plans, and have even changed my work to be much less stressful. I also do vibrational healing and have recently returned to getting acupuncture. Last week I tried a “hormone balancing” supplement for a week (thinking this was perimenopause) which made me gain MORE weight.

    While my energy has gotten better many other symptoms persist which is confusing. I am just at my wits end – especially right now with my weight. It is so frustrating to not get this to turn around with everything I have tried.

    Any suggestions are GREATLY appreciated. Again, thank you for all of your insightful work.

  • Sharon says:

    Hi Dr. Lam….I have AFS from menopause…I seem to be getting steadily better, I have changed my diet, I am taking supplements that support my thyroid, menopause and started acupuncture two weeks ago. My cortisol is high and have that wired and tired feeling…I am able to rest in the day and take naps. This past weekend I was sleeping a bit better, I am in bed by 10:00 p.m. I go for little walks in the sunshine. My partner and I are making efforts to ensure low stress for both of us. I do things a bit at time. I have had a difficult time looking for the right Adaptogen to help lower my cortisol levels. I had too much magnesium which made me ill and I cannot take Dong Qui….What would you suggest ?

  • Jack Ryan says:

    I am a 28 year old male. I took a six week road trip solo where I ate poorly, had a huge lack of sleep, partied a lot and drove six to eight hours a day. By the end of it, I was so exhausted from the neck down I could barely stand. Four weeks later I’m taking ridgecrest adrenal fatigue and other vitamins. I have anxiety attacks twice a day. Some days I feel fine, others I feel consistently tired. I have no symptoms other than fatigue and anxiety. Two doctors said nothing was wrong with me and I was burned out after examining me and taking blood tests. How long till I get better?

  • Bonnie says:

    What do you reccomend for people who have the abnormal recovery “C”. I have only gotten worse and worse over 27 yrs I have been sick. I am now 39.

    • Dr.Lam says:

      That is a sign that your body is not getting what it wants and the tools it needs. This can include many things, including herbs and glandulars. The body could also be overstressed over time and did not have enough time to repair, leading to relapses. Your constitution may also plan an important role. Too many factors are at play. A detailed history is needed to sort things out. Laboratory test is not going to help. The good news is that once the underlying root problem is resolved, the body then can get back on track to recovery generally speaking.

      Dr Lam

  • Emily says:

    I am currently suffering from, I what I believe to be, adrenal fatigue. I have almost finished reading your wonderful book, and I am working on correcting my diet, but I would like help with knowing what supplements are right for me. I have self-diagnosed, from reading your book, (I know you probably cringe when you hear the terms “self-diagnose”) myself to be early stage 3. I experience brain fog, heart palpitations at night which wake me up, sore neck, back, and shoulder muscles, fatigue, anxiety, difficulty coping with normal everyday problems, difficulty getting started in the morning, etc… Any advise on supplementation would be very helpful.

    • Dr.Lam says:

      I have listed many in the book, along with the pros and cons. The right supplements are the ones that fit your specific body at the specific point in time. Symptoms give us an indicator only, but does not tell us enough about your past history, constitution, current sensitivities, environmental concerns etc which can all influence the ultimate solution. Unfortunately, we deal with many who come to us not having the “right” supplement. The concept that there are supplements that are absolute for each stage is incorrect. It does not work in conventional medicine either,and that is why you have to see your doctor for proper evaluation and why there are so many different kinds of drugs for similar issues – because not everything work for everyone on a blanket basis. The same is true for nutritional support.

      Dr Lam

      Dr Lam.

  • Quenton says:

    Recovery can seem like a long road… do you have any words of encouragement for someone trying to navigate the ins-and-outs of this? Thanks so much Dr. Lam.

    • Dr.Lam says:

      Most of us are not taught to learn to listen and sense what our body is telling us. This process takes time to pick up and the right interpretation. Most self navigation fail because a multitude of factors, but those rank among the top, in addition to improper intepretation Click 7 Adrenal Fatigue Recovery Mistakes for more information. of test and wrong use of supplements.

      Dr Lam

  • G from Toronto says:

    I am an AF sufferer and will have another surgery soon. Can you please provide me with foods/fruits that can support my recovery. Thank you so much.

  • Gabi says:

    I feel like my doctor doesn’t really get adrenal fatigue. Please don’t misunderstand, he is behind me all the way with believing that I have it, but he just doesn’t know what to do. We’ve tried a few things based on your articles, but I’m still quite tired and lethargic. Do you have any advice for my doctor?

  • Jennifer says:

    How long does it take to recover from Adrenal Fatigue?

    • Dr.Lam says:

      Depending on the stage you are in, a good program takes from 6-24 months. There are many exceptions and everyone is different.

      Dr Lam

  • Robyn says:

    I believe I have had Adrenal fatigue now for 35 years. Occasionally I have had healthy times but mostly I have operated at a lower well being level. My worst symptom for most of that time has been insomnia. As you can imagine over that time I have seen numerous doctors and naturopaths and have been tested for many things. Very little has shown up which has been very depressing and has put me off visiting experts. In recent years I have done lots of research, and have found that this site really nails my condition so well. I have been trying to self manage and it is extremely difficult. Unfortunately I can find no-one in Melbourne Australia that could guide me. I have regular paradoxical reactions to drugs and find few medical practitioners who understand this aspect. Do you have any contacts in Melbourne Dr Lam or does any other have a good contact? I am determined to refind the well being that I only glimpse occasionally!

    • Dr. Lam says:

      Your story is quite common. Dont give up hope. We serve many from around the world by telephone including many from Australia because sadly no one there really understand the concepts well enough and have enough clinical experience to solve this problem. As a last resort, you can call my office. Make sure you are very careful with any hormonal replacmements or glandulars. While they have their place, they are vastly overused and causes a lot of problem.

      Dr Lam

  • Janet Cook says:

    Thank you for your writings. I have read several of your articles. I have been suffering for 15 months. I crashed with severe fatigue in 7/14 and in Dec. ’14, I felt better in the fatigue area but still always had weird symptoms, like brain fog, or feeling jittery or anxious, sometimes dizzy or light-headed. But in June ’15 the severe fatigue returned and has remained consistent, including the other weird symptoms. By way of saliva testing, at Pharmasan Labs, in two tests, one in the end of 2014, and again recently, I am showing low cortisol levels in the a.m. and afternoon and rising slightly at night. I’ve been to 20 docs. They eventually diagnosed me with CFS. No one acknowledges Adrenal Fatigue except the two naturopathic docs. The problem is that I continue to get worse and I’ve hit a wall. No one has actually helped me with treatments; I’m on my own figuring all of this stuff out by reading online. I have received some guidance from a few docs but very little. I don’t know what I’m doing right, or wrong. Your articles speak of many things people do wrong, and at the same time, you mention that everybody is different and that things should be very individualized. Obviously, this makes sense. But I still have no idea if I’m doing anything right, or what I’m doing wrong. I stay in bed most days. Here’s what I’m doing: Vitamin C about 3-4 thousand mg. a day, just a pill form. Vitamin A 8,000 I.U., B Complex 100 mg. of ea. B, Olive Leaf Extract 500 mg. (2 pills daily), Age Loc Vitality (Panax Ginseng and Cordyceps mushroom), Vitamin E 400 I.U., Flax seed oil 1000 mg., NeuroScience AdreCor with the Licorice Root 1 pill daily in a.m., Echinacea 500 mg., Vitamin D 5000 I.U., Testosterone cream daily, weekly estrogen patch .075, alternate Levothyroxin .75 with .88 (I used to be on higher dosages before I got sick but I can’t tolerate those higher dosages anymore because I get jittery – this is even before I started all of the many supplements, and BTW, I was on Thyroid meds for about 15 years before I got sick so hypothyroidism has always been an ongoing diagnosis). I just keep getting worse or stay exactly the same. There are days, no more than one or two, that I think I feel more normal, but they don’t last. I recently bought Zinc and Selenium but have not consistency taken those and I’ve just recently added DHEA 25 mg. I feel like I’m on too much crap. I’m not getting any better. I have many other weird symptoms such as brain fog, heavy strange feeling in my head when I drink too much water, increased fatigue after I eat or drink water, feeling hot, sweating, and many other stuff. I also have low I.g.G’s in all of the subclasses except subclass 1. I have low CD 19+ B cells, I also have low immunity to vaccine test, 37 percent response. I was recommended I.V.I.G. therapy by way of the immunologist and await insurance review. I am so sad and tired of feeling like this. I have no life anymore and I don’t do anything anymore but stay at home. I had to quit my non-profit that I started 6 years ago. Some of the vitamins help me feel better but they’re just surges of energy, really. I never feel normal anymore. I have not felt normal in 15 months. I have tired I.V. vitamin treatments, and they just wipe me for a week. So I quit that. I have been to acupuncturists, which seems to help a little, but I can’t seem to find an acupuncturist that does not have to keep running off to Korea for a month’s time so my treatments are not consistent. I am also recently going to massage therapy. I feel as if my life is over and I’ve very sad. I don’t know what I’m doing right, or wrong. I’ve seen 20 docs and have had every test known to man. Again, there are a few days where I fool myself into thinking that I’m getting better, but it never lasts and I’m always back to square one. Please help me Dr. Lam if you can. Thank you!

    • Dr. Lam says:

      Sad to say but obviously you are not on the right track with what you describe. Unfortunately, what you experienced is quite common of those in late stages AFS after the body has no more resilience. No surprise. The body is already very weak and its nothing will work until you first stabilize the system.

      Nothing you mentioned is unusual, so first do not be despair. Many have recovered even from this stage. We deal with people like you daily. You need to find a doctor who fully understand and knows what he is doing as that is the starting point with the degree of severe decompensation as the slightest wrong move can make things even worse.

      Dr Lam

  • Arnold Pitza says:

    Thank you Dr.Lam for taking the time in creating this information. It really does help.

  • Batman says:

    I am suffering from insomnia 4-5 years,unable to sleep deep as well as waking.This started due to the sudden weight loss due to GM crash diet.Till now not recovered.
    When i exercise in the morning and evening times,i have more sleeping problems.
    But,When this problem was started,i exercise every morning and my sleep become normal after a month.But, unknowingly i stopped my exercise that time since i was not aware that the exercise corrected my sleep.Again problem started.After few months only,i realized that.

    • Newsletter says:

      Timing of exercise can make a big difference in your sleep pattern. Adrenaline released during exercise can make you tired and sleep easier, or it can release so much adrenaline that cause you insomnia. you have to experiment with it. Usually exercise in mid afternoon is best as your body is warmed up and have ample time to burn of the adrenaline. Also mid afternoon exercise has been shown with the least frequency of heart problem that can come on easier when the body is not warmed up in the morning . My article on Biological Rhythm is a good read if you have an inquisitive mind.

      Dr Lam.

  • nellie duplessis says:

    My grandson only have one kidney. he is allergic to most of the food, he has leaky gut and is loosing weight, can it be because of adrenal insufficiency. He can not go to school any more he is getting very weak. please answer! they say he might have Mast cell activation syndrome, can it be? of adrenal insufficiency
    I thank you Nellie Du plessis

  • Cathy says:

    I believe I have been suffering adrenal fatigue for many years. The past two years have been the worst. Like Anita explained, some days I have enough energy to do most of what I need to do. Other days I can barely get off the couch. I am never sure if I should force myself to do more. Am I doing my body good by watching tv, reading, doing puzzles?

    • Newsletter says:

      Slowing down and rest is good, but the body doses need some form of exercise, or it can get more catabolic and start loosing muscle. My book has the Adrenal Restorative Exercise set which many find helpful ,especially those who are bedbound or housebound. Do not be discouraged, but you need to focus on getting more educated so you know what you need to to do to start on the road to recovery. What you experienced is not unique. We deal with many like you and you are not alone.

      Dr Lam

  • Newsletter says:

    The best long term approach to recovery is to give the body the tools for it to built hormones needs by itself. to do this, you need to avoid herbs such that what you mentioned. you want to avoid stimulants. The problem is that many people like these herbs because they tend to prop up the body. You do pay a price in that the underlying root problem is often masked as a result. If you are already on these, do not stop abruptly as you can get into withdrawals. Read my article ” Total Body Approach to Adrenal Fatigue Syndrome” and my book of 500+ pages will be a good read for you if you have an inquisitive mind because it lays out for the right steps to take for long term recovery rather than short term patches.

    Dr Lam

  • Anita says:

    For the past several years, I have been trying different approaches in my battle against adrenal fatigue. There are good days when I have energy to do everything I need to do and more, and then terrible days where I don’t remember what those good days were like at all. I have not had consistent energy for years. What do you recommend I should do to build up consistent energy? I’ve heard about herbal supplements like Ashwagandha and Rhodiola can help with energy…what do you think about that?