By: Michael Lam, MD, MPH

Adrenal Fatigue

AFS 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 AFS

This list is not intended of you to self diagnose AFS. 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.
5 stars - "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.

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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


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.


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,