By: Michael Lam, MD, MPH

Adrenal Fatigue

Adrenal Fatigue Syndrome can present itself in association with any of the following signs, symptoms, or conditions. Because there is no definitive laboratory test for this potentially debilitation condition, always be the alert if you have any significantly number of the following.

Not everyone has all of the symptoms or conditions listed below. The number varies from person to person, but if you take a step back and look from afar, they collectively paint a picture of a body under threat. The higher the prevalence or intensity of the items listed below, the higher the chances that you may have Adrenal Fatigue Syndrome.

  1. Unable to fall asleep despite being tired
  2. Wake up in the middle of the night for no reason
  3. Heart palpitations at night or when stressed
  4. Low Blood pressure consistently
  5. Low libido and lack of sex drive
  6. Low thyroid function, often despite thyroid medications
  7. Feeling of hypoglycemia though laboratory values are normal
  8. Depression, often unresolved after anti-depressant
  9. Endometriosis
  10. Polycystic Ovarian Syndrome
  11. Uterine fibroids
  12. Fibrocystic breast disease
  13. Hair falling off for no reason
  14. Irritable under stress
  15. Anxiety
  16. Panic attacks
  17. Feeling “wired” and unable to relax
  18. Feeling of adrenaline rushes in the body
  19. Fogging thinking
  20. Inability to handle stress
  21. Waking up feeling tired in the morning after night’s sleep
  22. Feeling tired in the afternoon between 3:00 and 5:00 pm
  23. Inability to take in simple carbohydrate
  24. Coffee needed to get going in the morning and throughout the day
  25. Coffee, tea or energy drinks triggering adrenaline rush and adrenal crashes
  26. Feeling tired between 9:00 and 10:00 PM, but resists going to bed
  27. Craving for fatty food and food high in protein
  28. Craving for salty food such as potato chips
  29. Dry skin more than usual
  30. Unexplained hair loss that is diffuse
  31. Exercise helps first, but then makes fatigue worse
  32. Chemical sensitivities to paint, fingernail polish, plastics
  33. Electromagnetic force sensitivity, including cell phone and computer monitors
  34. Delay food sensitivity, especially to diary and gluten
  35. Unable to get pregnant, requiring IVF
  36. Post partum fatigue and depression
  37. Recurrent miscarriages during first trimester
  38. Abdominal fat accumulation for no apparent reason
  39. Temperature intolerance, especially to heat or sunlight
  40. Dysmenorrhea advancing to amenorrhea
  41. Premature Menopause
  42. Constipation for no apparent reason
  43. Joint pain of unknown origin
  44. Muscle mass loss
  45. Muscle pain of unknown reason
  46. Cold hands and feet
  47. Premature aging skin
  48. Inability to concentrate or focus
  49. Psoriasis of no known reason
  50. Gastritis despite normal gastroscopy
  51. Low back pain with no history of trauma and normal examination
  52. Dizziness for no known cause
  53. Fructose mal-absorption
  54. Tinnitus (ringing in the ear) chronically
  55. Numbness and tingling in extremities bilaterally
  56. Mouth sores recurrent
  57. Short of breath even though breathing is fine
  58. Ovarian cyst
  59. Breast cancer associated with estrogen dominance
  60. Grave’s disease
  61. Hashimoto’s thyroiditis
  62. Legs that feel heavy at times
  63. Dark Circle under eyes that does not go away with rest
  64. Loss of healthy facial skin tone color
  65. Body feel tense all over and unable to relax
  66. Postural orthostatic tachycardia
  67. Irritable Bowl Syndrome, with more constipation then diarrhea
  68. Chronic Fatigue Syndrome unimproved with medicine
  69. Fibromyalgia unresolved after conventional help
  70. Systemic Candida that gets worse when under stress
  71. Electrolyte imbalance despite normal laboratory values
  72. Irregular Menstrual Cycle that “stops and go”
  73. Lyme Disease but unable to fully recover after medication or intolerance to drugs
  74. H Pylori Infection in the past and was told resolved but never feel the same since
  75. Heavy metal and mineral toxicity may mimic Adrenal Fatigue Syndrome
Related Post
  Simple Quotes for Life

This list is not intended of you to self diagnose Adrenal Fatigue Syndrome. If you think you may have Adrenal Fatigue Syndrome, the first task is to get more educated. Because of the rather convoluted and complex nature of this syndrome, always consult a qualified health professional prior embarking on any recovery plan. Most recovery programs fail and the condition may worsen if you lack a clear understanding and what lies ahead.


© Copyright 2012 Michael Lam, M.D. All Rights Reserved.

Adrenal Fatigue Questions

What is Adrenal Fatgiue?

Adrenal Fatigue is a state of sub-optimal health applied to a collection of non-specific symptoms such as weakness and low energy that is hard to explain. Most forms of Adrenal Fatigue are mild, with full recovery after rest, and therefore they will go undetected. If the condition is left to natural progression and the stressors continue to persist, Adrenal Fatigue may worsen. Advanced Adrenal Fatigue can be incapacitating. Physical or emotional stress (such as toxic relationships) plays a big role in this condition.

What does Adrenal Fatigue feel like?

Feeling of adrenaline rushes in the body, brain fog, inability to handle stress, waking up feeling tired in the morning after a full night’s sleep, feeling tired in the afternoon between 3:00 pm and 5:00 pm, inability to take in simple carbohydrate, feeling tired between 9:00 and 10:00 PM, but resists going to bed, craving for fatty and high-protein foods, craving for salty food such as potato chips, dry skin more than usual, unexplained hair loss that is diffuse, meaning it is spread across the entire scalp.
5 - "Hi, Dr. Lam!!!!!" Hi, Dr. Lam!!!!!

At this point I am so encouraged that you have set up a forum through which those of us with adrenal fatigue can find hope through answered questions about the dynamics of healing. For one, it is such a comfort that you have stated up front that healing can be plotted along a Recovery Curve with multiple mini cycles in between. So, thanks again.

Leave a Reply

Your email address will not be published.


Lori Burgan

I have many of the symptoms listed. I also have pain on right side in kidney area, I heard that this could also be symptom. Is this true?


there is no direct somatic type nerve innervation to the adrenals. Some people complain of a dull ache discomfort to the area around the kidneys when under stress.

Dr Lam

Adriana LaMarchina

Hello Dr. Lam and thank you for your site. I had unilateral adrenalectomy after tumor was spotted on adrenal gland. It was never really known if it was a functioning tumor but I was very sick, no energy, pain issues, not sleeping, etc, so the adrenalectomy was done in 2003. I still have problems and have 75% of the symptoms of adrenal fatigue. Am not under any real medical care for lack of insurance but am struggling just to live my life with no energy, constant pain, depression, nausea, moderate hair loss, irregular periods, insomnia, heart palps, bouts of horrible gastritis, etc. Any suggestions are greatly appreciated. Do I just need to find another endocrinologist and take steroids as I’ve done a couple of times in the past? Not sure how much it helped long term.


Dr Lam…I’ve been having problems ever since my thyroid went overactive in 1985. It became normal within the year. Then, in 2003 it became overactive again. That is when the issues began to mount. I was on Tapazole for 5 years and decided to get off of it in 2008. The Dr. wanted me to nuke my thyroid. I said no thanks. My thyroid was within “normal” lab limits but still the issues persist. An osteopath and a neurologist I had seen both think there is an issue with my adrenals, however, the labs (epinephrine, norepinephrine, dopamine) are always within normal limits. A saliva test showd low cortisol from the afternoon on, which coincides with bouts of sleepiness. Would test results for the neurotransmitters be out of whack if my adrenals are not functioning properly. I happen to agree with these two Dr.’s, but I am just looking for concrete proof before I begin any adrenal support. What are the best tests for adrenal activity?? I am wondering if the whole thyroid issue might have been adrenals to begin with as I never had a sweet tooth, never ate chocolate or cared for soda until my thyroid went overactive.


Neurotransmitter test are not very accurate when AFS is present and having normal values are normal for that setting. Saliva test are not very good either. there are many reasons for low cortisol in the afternoon. The best is detailed history. You have to wait 20-30 years at least for “concrete proof” . Adrenal support , given your overactive thryoid and normal, needs to be very careful and avoid compounds that potentially may be stimuating including hormones, glandular and herbs.

Click Adrenals & Thyroid Connection for more information.

Dr Lam


Dr. Lam, I’m a Type 1 Diabetic who has had quadruple bypass surgery 3 years ago. I have many of these symptoms but there is one thing that I have that is not listed. I almost consistently have a headache and my BP is low. Could this be the cause of my headaches?


I have probably 85% of your symptoms due to my father being hospitalized for over a year and doctors that are uncaring idiots (I worked in allopathic medicine for 34 yrs). There is one symptom I have that you did not mention, and that is the inability to get my heart rate to increase under exertion (weight lifting or cardio). I have been an athlete for years (bodybuilder) and this is making my training impossible. Is this also a sign of adrenal fatigue?


that is not common, and it may reflect underlying issues which need to be explored by detailed history assuming that there is no structure problems with your heart.

Dr Lam


I can relate to almost every symptom listed here! How is that no conventional doctors can see the correlations here??

Raphaela Sorkin

Hello Dr. Lam. My daughter and me we both have adrenal fatigue. She is 23 years old. It’s horrible the way she feels all the time. Every single symptom you have listen she has. Please help. What can buy, what kind of medicine to get some kind of help.


Your first step towards recovery is to get educated more. Read Adrenal Exhaustion for more information. you can self navigate , and my article and my book will be an excellent resource for you to get started to read. Remember that everyone is different, so what may work for you may not work for your daughter. There is no harm to try, and if you dont get better, then you need to seek further professional help or call our office. I do not suggest you blindly take supplements because it can make you worse.

Dr Lam


would love to hear from others about this, have been having these problems for a while, very stressful and you feel out of control as well as ill – perhaps we can help and support each other. pleaes write to me at ry chh mo at a ol dot c o m without the spaces. thanks.

Zachiry Mulshivet

Wow, there are many intimidating symptoms that one can have. How many symptoms should i be showing before I concern myself with Adrenal fatigue ?


The symptoms list is very comprehensive to factor in all kinds of people. Most people have 5-20. The lower the number, the less concerning unless it is very intense. Some people only have insomnia,or heart palpitation and get better when the adrenals are healed.

Dr Lam.


With this can muscle twitching and mood changes be a symptom?.. Also i find that when i exercise (not strenuous) my body temp drops significantly lower than before i started!

Leanne Pratt

Hi Dr Lam, I notice you mention tiniitus as a side effect of adrenal fatigue. I have stage 3-4 adrenal fatigue, slowly on the mend. But one of my biggest issues is tinnitus – it is worse when I have bad fatigue, brain fog days, and also lessens when I am having good days. Can you explain why adrenal fatigue sufferers get this tinnitus – I cant seem to find any explanation for it in any readings. Many thanks 🙂


I wish I can fully explain the matter of tinnitis in a setting of AFS but I cannot. What I can tell you is that clinically we see that quite often. It is often associated not only with fatigue also associated with accompanying sympathetic overtone and with glandular and herbal use. We think it has something to do with norepinpehrine overload triggered as a result during Stage 3 Adrenal Fatigue referred to as Adrenal Exhaustion Read Adrenal Exhaustion for more information.
Sometimes it can be quite severe. Most of the time, it gets better as the adrenals are put on the right course and recovers. Sometimes it get worse and usually if you trace it deep enough, there are some hints. Because it is not common, most practitioners will miss it unless on the lookout and on alert. Unfortunately, by the time most clients have this problem, they are on a battery of supplements and meds that can mask the underlying root cause. The key is to slowly clean up the body and trace it to the root and fix the root cause as tinnitus is a symptom and not the cause. It can be done, but does take time, patience, and some trial and error even in the best of hands.

Dr Lam


What a great article! I find many of these very interesting but would like to know more on each topic, particularly “Joint pain of unknown origin”, “Muscle Loss”, and “Fibromylagia”. Can you point me in the right direction?


Thank you very much for your time and consideration regarding my question about my 16 year old son with AFS. I will mostly concentrate efforts toward healing with foods and limit supplementation.
Thank you,


Thank you for your insights and knowledge. My 16 year old son was diagnosed with AFS by our homeopathic Doctor. She put him on a four week elimination diet with no sugar, wheat, rice, corn, soy, or dairy , and just to eat green vegetables , meat and berries. She also has him taking 42 herbal supplements a day as well as d3 drops. He has been resisting taking the supplements. Do you think the elimination diet will help without all the supplements she is prescribing? He also suffers from anxiety and low motivation or confidence. Thank you!


Teenagers have a very different set of problems and challenges when it comes to AFS. Read my article on this very subject here to start. I personally do not believe that supplementation for young people should be the major focus for recovery because their body is usually strong and more is not necessarily better as it take a lot of energy to process these nutrients. Some selected and target ones are ok. Do be careful of over supplementation. Anxiety and low motivation often is a sign of underlying imbalances that tend to reduce as adrenal heals, but you should check with your doctor. Avoid drugs unless no choice.

Dr Lam.

Jamal Lurken

Thank you Dr. Lam for taking your time to educate those who seek this information. I’ve battled with adrenal fatigue for over 15 years. Im worried that my children might have to go through the same issues, how can i prevent this from happening to them ?


Thanks for your kind words. We do see a high prevalence of parent-child connection. Many kids starts to show some adrenal fatigue in early teens, but we see some as early as 8 years old, sad to say. First you dont want to jump to conclusion because sometimes kids get tired from overactivity. But if you notice a trend developing, then see you regular doctor first to make sure all is well. If nothing else comes up, you can first eliminate corn, diary, wheat and go gluten free and soda free. Most kids do get better with just that. If not, then a more detail history is needed. Our experience is that even if kids have AFS, they rebound very fast and can resume normal activities provided that you allow the body to heal with natural compounds titrated right for the body and very importantly, avoid stimulants. Supplement may be helpful but not always and we try not to use them as the body self heals in young people and we dont want to put the body on any dependency issue by propping them up.
Hope this helps

Dr Lam