Adrenal Journal

By: Michael Lam, MD, MPH

A recovery journal is important for those recovering from Adrenal Fatigue Recovery from adrenal fatigue requires an attention to details that only a properly kept journal can accomplish. This is a very valuable tool. Having a journal lets you keep good notes on what is recommended for you to do during your coaching session. It forces you to be detail oriented and not to forget recommendations. It allows you to reflect on what was done right and wrong daily and track any immediate adjustments made before too much time has lapsed and damage is done.

Over time, and with our guidance, your journal will serve as a self-navigational tool that will help you to recover from adrenal fatigue.

Equipment: One notebook and pen.

Things to put in your journal:

1. Your supplement instructions

As you were instructed by your coach. Unless otherwise instructed, all supplements are to be taken with food and can be mixed. The morning dose is taken with breakfast. The lunch dose is taken with lunch before 2 pm. Unless otherwise instructed, no supplements are to be taken after 2 pm.

You will often hear the abbreviation "2/1" which means 2 doses at breakfast and 1 dose at lunch, or "2/2" which means 2 doses at breakfast and 2 doses at lunch. If your coach says "1/1/1", this means one dose each at breakfast, lunch, and dinner. "1/1/1/1" means one dose each at breakfast, lunch, dinner, and bedtime. If an afternoon dose such as 5 pm is needed, it will be specifically mentioned.

Generally one dose is equal to 1 pill or 1 teaspoon unless otherwise mentioned. Sometimes drops are used in which case you will be told specifically ahead of time how many drops to take.

All doses are taken orally unless otherwise instructed. Occasionally, we may need to use topical (apply to the inside portion of your wrist) or sublingual (under the tongue) as will be indicated.

2. Fatigue and Energy Scores

a. Fatigue Score

Please refer to the table below and record the score you are most comfortable with:

My Overall Fatigue Score For the Day

  1. Peak energy
  2. Full of energy plus 20% to spare
  3. Good energy throughout the day, but can use more
  4. Average energy. Tired when going to bed
  5. Feeling tired all day
  6. Extremely tired all day
  7. Bedridden

For example, if today you feel that your overall energy is somewhere between average (5) and good (3); you assign an overall fatigue score of 4. Write this number down at the end of the day's journal entry as an overall record of how you feel, and circle it for easy reference.

b. Energy Score

Optional energy scores you can consider to enter, if applicable, include:

Amount of resting time I need (hour) in order to not feel tired % of normal outside activity I can do without getting tired % of household chores I can do without getting tired
0-24 hours 0-100% 0-100%

For example, if you needed a 30 minute nap in order to get you through the day smoothly (whether you may or may not take the nap); your score is 0.5. If you were capable of doing or did 70% of the outside chores, such as a job or run your normal load of errands, your score is 70. If you were capable of or did 90% of your normal household chores without feeling tired, your score is 90. Your entries for these categories would look like 0.5/70/90 if you do all three. It's best to do all three, as one set if you choose to do it, because together they form a picture of the energy status overall. If you have no reference to any one of these subcategories as being relevant, then enter "0" for that energy category. For example, if you are a homemaker and do not do outside work at all and have no outside errands to run, then your entry would be 0.5/0/90.

3. Optional categories:

  1. Diet and food intake, as well as restrictions and adjustments.
  2. Exercise regiment, paying special attention to how you feel and how much energy is left AFTER exercise.
  3. Sexual activities and if you feel drained afterwards.
  4. Hypoglycemic episodes, frequency and intensity, and the time between episodes.
  5. Bowel movements and pattern, especially if there is constipation, loose stool or diarrhea.
  6. Sleep pattern, breaking down if the problem is going to sleep (sleep onset insomnia or SOI) or the problem is waking up and being unable to go back to sleep (sleep maintenance insomnia or SMI). What you took in terms of sleep aid and other sleep supports. What time you go to sleep and what time you awaken is also important. Sleep is especially challenging, and consistent recording is necessary to spot a trend.
  7. Emotional states such as anxiety, depression, jittery, anger, or irritability.
  8. Menstrual cycle tracking and symptoms.

If any one of these is of a particular concern to you, start your own journal tracking these on a scale of 1-10, with 10 as the worse, 5 being average, and 1 being the best. For example, if you have had no hypoglycemic episodes today, the score is 1. Let us know your numeric score during coaching. The importance of these parameters will be evident to you over time. Do not track more than 3-5 categories at any one time, as it can become stressful and overwhelming. You can always add categories to track later. Focus on the key categories to start.

We focus on fatigue and energy first, because energy is a sum reflection of most other underlying root issues in adrenal fatigue. When the fatigue and energy levels improve, many of the underlying symptoms, such as sleep and anxiety, will have automatically improved as well.

A good habit to have is to do all the scoring and recording at the end of the day, and to put the relevant scores on the bottom of each day's entry, along with a brief note of what transpired that day, and if there were any changes.

4. Do not over journal.

If you don't have anything special to put in your journal and you have no overall change, you can just skip to the next day. The key is to have something recorded when a significant event takes place that will alter the scores, the most common of which is the adrenal crash. If you did not have a crash and have a negative event that occurred (such as a loss of a loved one or having an infection) , do record that along as it will show the amount of adrenal reserve and how the body is able to withstand stress. When there is a significant change in any of the scores, please take some time to reflect on the reasons why and write it down.

The journal should be informative and act as a reminder for recollection purposes. Do not get stressed out doing this. Usually it takes no more than 5-10 minutes a day. All the information is for your personal use only. Any questions should be recorded.


© 2008  Michael Lam, M.D. All Rights Reserved.

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