75 Signs and Symptoms of Adrenal Fatigue Syndrome

By: Michael Lam, MD, MPH



There are many symptoms of Adrenal Fatigue The presentation of Adrenal Fatigue Syndrome (AFS) can be affiliated with any of the following signs, symptoms, or conditions. Currently, there is no definitive laboratory test for AFS but you should always be on the lookout if you are suffering from a high number of the following Adrenal Fatigue symptoms.

It’s important to note that not everyone has all of the signs and symptoms listed below associated with Adrenal Fatigue. Everyone’s body is different, and as such, every body presents differently. However, the higher the intensity and the more widespread the symptoms listed below are, the higher the likelihood of having Adrenal Fatigue Syndrome becomes.

Characteristic Symptoms of Adrenal Fatigue

  1. Unable to fall asleep despite being tired
  2. Waking up in the middle of the night for no reason
  3. Heart palpitations at night or when stressed
  4. Consistently low blood pressure
  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-depressants
  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. Foggy thinking
  20. Inability to handle stress
  21. Waking up feeling tired in the morning even after a full night’s sleep
  22. Feeling tired in the afternoon between 3:00 and 5:00 pm
  23. Inability to take in simple carbohydrates
  24. Needing coffee 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 still finding it hard to go 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. Delayed food sensitivities, especially to dairy 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. Chronic Tinnitus (ringing in the ear)
  55. Numbness and tingling in extremities bilaterally
  56. Recurrent mouth sores
  57. Shortness of breath even though breathing is fine
  58. Presence of ovarian cyst

Cancer as a result of estrogen dominance is one of the symptoms of Adrenal Fatigue

  1. Breast cancer associated with estrogen dominance
  2. Grave’s disease
  3. Hashimoto’s thyroiditis
  4. Legs that feel heavy at times
  5. Dark circles under eyes that do not go away with rest
  6. Loss of healthy facial skin tone color
  7. Body feeling tense all over and unable to relax
  8. Postural Orthostatic Tachycardia
  9. Irritable Bowl Syndrome, with more constipation than diarrhea
  10. Chronic Fatigue Syndrome unimproved with medicine
  11. Fibromyalgia unresolved after conventional help
  12. Systemic Candida that gets worse when under stress
  13. Electrolyte imbalance despite normal laboratory values
  14. Irregular menstrual cycle that “stops and goes”
  15. Lyme Disease but unable to fully recover after medication or intolerance to drugs
  16. H. Pylori infection in the past and was told resolved but never feel the same since
  17. Heavy metal and mineral toxicity may mimic Adrenal Fatigue Syndrome

This list is not intended for you to self-diagnose Adrenal Fatigue Syndrome. If you think you may have some of these symptoms of 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 of the symptoms of Adrenal Fatigue and what lies ahead.
© Copyright 2012 Michael Lam, M.D. All Rights Reserved.


Dr. Lam’s Key Questions

Is an Adrenal Fatigue diet high enough in calories to support a healthy pregnancy?

Good question. There are several aspects to a diet for AFS are very helpful for healthy pregnancy also. Avoidance of inflammatory foods such as caffeine, alcohol, sugar, trans-fats, processed food, etc. Eating smaller meals to keep blood sugar balanced throughout the day, and should give you enough calories to support a healthy pregnancy.

How does yoga help those suffering from Adrenal Fatigue?

Yoga exercise can be very mild or very intense. With proper guidance, the exercises can be personalized to your need. DrLam’s Adrenal Yoga Exercise is a good example of how to increase the intensity as you improve your AFS.

Is there a way to build muscle without bringing the heart rate up too much, which adversely affects those with Adrenal Fatigue?

Any time you need to build muscle, you need to strain those muscles. As a result, you can affect the heart rate. There should be no issues if your adrenals are strong and able to handle the stress of heavy exercise.

I’ve read that having a sodium/potassium imbalance is a sign of adrenal fatigue. I’ve been taking potassium pills for the last several years. Should I still continue or is that something I need to stop?

Most people take potassium pills because the doctor prescribes it for certain blood pressure medication. You need to check with your doctor whether to continue or not because potassium balance is very critical to be well maintained and is not something you should self-navigate.

Are there any exercises that a person could do that would give them a good idea if they have AFS or not?

If you don’t have advanced stages of AFS, any exercise is good for the body provided they are not extreme. Walking, biking, hiking, yoga and flexibility exercise in moderation are all safe for everyone. If you have advanced stages of AFS, make sure you follow professional guidance before embarking on exercise.

Adrenal Fatigue Recovery Coaching

There are many symptoms of Adrenal Fatigue

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135 Comments

  • thomas parton says:

    Low blood pressure in mornings and must take table salt until after lunch, I am a diabetic type 2 taking thyroid medicine but controlling by diet. My drs say just take salt’ I know this is just covering a Hidden problem. I am supicious of my adrenal gland or thyroid. This is very bad , i have to limit all my appointments and activities until afternoons. some time i have to take salt about every 1/2 hour until 2:00pm

  • Paulie says:

    Didn’t realize there are so many symptom signs of adrenal fatigue! Thank you for this valuable information.

  • David says:

    It’s scary how many of these fit me!

  • Erika says:

    My partner and I have tried for over 5 years to get pregnant. I know I have PCOS, but all they tell me is I have too much testosterone, not enough progesterone so they say to possibly start clomid. Isn’t there a natural way to regulate these hormones?? I am so tired of all thi9s testing and it feels like they are not solving my problems.

  • Charlotte says:

    Hi! It seems you’re the only doctor who understands what I’m going through. I have 3 highs and low Via saliva test. My vitamin d, magnesium ave other vitamins are low. Borderline hypothyroid again. My problem is, I’m constantly dizzy 24/7. The lightheaded never goes away. I also can not tolerate any supplements. When I try to take small doses of anything I wake up at 4am with extreme dizziness, extreme anxiety, very fast heart rate and very jittery. I’m not sure how to get better if I can’t tolerate anything that’s going to help. Any insight would be greatly appreciated!! I have two children and I can’t live my life at all. I barely function throughout the day due to my dizziness. Thank you!!!

  • Henry says:

    If all you have of these is severely debilitating brain fog.. is that still AFS? Thanks in advance..

  • Yuliana naranjo says:

    I don’t know if I have adrenal fatigue all I know is that I have panic attacks for years and anxiety and I take anxiety med and about 2 years ago my brain went completely numb is hard for me to focus and I’m. Mom I done ctscan my brain is okay I went to neurologists he said I’m okay but why do I feel my head numb like there’s is no oxygen in it I never felt it before I do t know what to do I also did bloodwork I’m ok too please help me .

  • Elizabeth Jones says:

    I had my left adreanal gland removed in nov 2016 ,it was found that i had a non cancerous tumer,after that i was put onsteroids hydroquterzon and was told that i would be seen in jan2017 to start reducing the dose,but i am still waiting for a appointment after many calls to try to see the doctor,i am feeling very unwell with numbness in legs and arms very tied all day,should i reduce the steroid myself can not get Gp appointment for three weeks.

  • William Voll says:

    I get a hot sensation in my left chest area followed by a high heart rate and feelings of impending doom. Sometimes heart can go to 150 beats and I use vagel maneuvers to slow it down and deep breathing. I feel inappropriate adrenaline rushes also. All tests have come back with nothing except borderline high norepinephrine limits and high dopamine levels.

  • Boston says:

    Do thyroid hormone replacements become less effective over time? Or is this a sign of adrenal fatigue?

  • ron says:

    good day dr iam a 33 years old man I suffer from most of the symptons you mention ,joint pain on my legs,shortness of breath,struggling to sleep,feeling tired early in the morning even though I slept ,struggling to concentrate for a long period of time and forgetting things like other words in my second language I depend on coffee and other sweet drinks to make it through the day and asa results im gaining weight

    • Dr.Lam says:

      This article will be a good read. If you have specific question pertaining to your situation, you can submit it in Ask the Doctor section in my website for a personalized response.
      Click Adrenal Exhaustion for more information.

      Dr Lam

  • Lisa Cappello says:

    Dr. I am a 38 year old woman, who is just trying to get answers on my severe chronic fatigue. As well as insomnia.(which isn’t as severe as my constant desire to sleep)!! I can sleep, without a care in the world for 4-7+days consecutively night and day. I only get up, cuz I am being yelled at or kicked out of house. Otherwise, I would just keep sleeping. I mostly toss n turn at night, awake, but too tired to get out of bed. But when the day hits, I am out like a light. Going to the bathroom is waited to as long as it hurts before I get up to go. Same with eating during this time. I get an energy bar or something quick, I can eat while in bed so I don’t have hunger pains anymore, so I can go back to sleep.

    When I look back to try and figure out when it started, I can’t remember my life not being like this. Getting worse as I get older. So 15-20+years I have been going thru life like this! Thought it was somewhat normal, in my head. Even tho I knew deep down, I wasn’t ok. I don’t have a job clearly and can’t keep one at all or for very long cuz of this. I take meds for Depression, Anxiety, Mood & ADHD So I have always chocked up everything thats wrong to my medication. I take Effexor, Lamictal, Klonapenz, Clonidine(as needed) and Adderall
    I also bartended for over 20 years(((worked in over 35 bars-couldn’t keep the jobs, but was good at bartending. Only reason I could’ve done it for so long))), so i assumed my sleep patterns were due to the lifestyle I had for so long. Worked at night and slept all day. Just was how it was. But I am not buying it anymore.

    5 years ago I was down to 80lbs due to abruptly stopping Klonapenz-Well I think thats why, anyway. I quickly gained 120lbs over the last 5years and am now 200lbs when I am normally 135. Can’t lose any of it.
    Since all of this, my stomach issues have gotten really bad.

    My family has a history of hyperthyroidism, fibromyalgia, deep depression,ADHD, etc
    I have always suffered from anemia, but recent lab works have said otherwise as well as me being healthy to everything being tested. Clearly, not accurate. Not sure what is going on with that.

    So I have read up on Chronic fatigue Syndrome, Hyperthyrodism, Adrenal Fatigue Syndrome, Fybromyalgia, IBS, Candida overgrowth, n I have ALL the symptoms of all of them. So now what?! As well as healthy blood lab results from being tested for a majority of these.

    If I don’t get a grasp on my sleep disorder like asap, I am not going to be able to continue like this anymore. I’m at my last straw. My boyfriend calls me a junkie, cuz I take pills for my issues and that to him makes me a drug addict. He’s never taken an aspirin, so I am to him, a severe junkie.
    So u can say my life has extremely bad environmental factors that also come into play. Which I am sure makes whatever I have that much worse.

    Because of this, I lost my job, my home, my cars, all my money, filed bankruptcy, lost what little health I had at the time. I am now living between my Dads n my boyfriends n hour away from each other. They both don’t want me at there places because of my sleep disorder. So its very stressful not being wanted. On top of being 38 years old and living at home with no job and no ability to work. With no understanding of this from either Dad nor boyfriend. They just think I should get a job and be normal like everyone else. But I can’t. I just want to sleep. I often find myself taking too much adderall, so that I don’t fall asleep, cuz if I do fall asleep, I know I won’t wake up, especially If I have to do anything the next day. If I do have something to do the following day, I will have to stay up the entire night prior and not go to bed, so that I can make appointment or whatever I have to do the following day.

    I have free medical care due to the severity of my past issues with health. Not sure what it covers besides what I already get. Medical and Mental Care. So if I need to see a specialist, I only can if its covered by health insurance. I have no income on top of all this.

    I tried to give as much info as I could to display my symptoms, etc I just don’t know what to do next. I need help, quick. Like I said, not much longer I can handle this, whatever, this, is!!

    PLEASE HELP, I’M DESPERATE!
    Lisa

    • Dr.Lam says:

      I understand your plight. Sleep is a major issue with most people in advanced stages. My article here will be a good read. Because the body is very fragile based on your history, you need to be very careful and not do things out of desperation that can potentially make you worse. Everyone is different. What works for one person will not work for another. To formulate a program it is necessary to take a very detailed history to find out where you are at in real time as first step.
      Click Total Body Approach for more information.
      Also Click Adrenal Fatigue & Sleep for more information.

      Dr Lam

  • Michael says:

    It’s amazing to me how many symptoms can signify Adrenal Fatigue Syndrome!

  • Desparate D says:

    Dr. Lam, i am a 36 year old woman who has NEVER had medical problems or even get sick. I have recently been under SEVERE stress in the past 4 months. At first i just felt unenthusiastic about anything which is not me, Ms. Positivity. I have been a fitness professional/nutritionist for years and recently changed jobs and moved. I started having less strength in workouts and fatigue for no apparent reason. Then over the past 2 weeks i started swelling in my feet, knees, legs, abdomen, and embarassingly my vulva! I have gained 20 lbs water weight during this time. I took myself to the ER and 4 blood tests and a kidney ultrasound later, no negative results. What is causing this and what can i do to reverse it? I never take medication except advil. I have never been pregnant nor am i. Please help! Meetint with a nephrologist tuesday but not hopeful

    • Dr.Lam says:

      Severe water retention like the picture you have painted is not common in AFS. You need to continue your work up with conventional medicine as there is much that needs further investigation.

      Dr Lam

  • Clare says:

    Dr Lam
    An endocrinologist told me my cortisol levels are borderline. I had a thyroid test which showed a high TSH and low T4, together with thyroid antibodies. A test taken a week later showed normal thyroid values and lower antibodies.
    I have spent the last 2 months on a auto immune paleo diet and supplements. I have slowly begun to feel better. Despite this,there have been 3 occasions when my energy has crashed, felt exhausted and dizzy (lasting approx. 1 week each time). Each time it was triggered by food allergy or stress.
    Do you think these are adrenal crashes or flares of autoimmune activity related to the thyroid antibodies, please?
    Thank you

    • Dr.Lam says:

      I am not sure because the details you provided are insufficient. A more more history is needed. Wrong supplementation can cause problems you mention. If you want to know for sure, you can call my office and with a more detailed history, I can tell you better.
      Click Adrenal Fatigue Glandular & Herbal Therapy for more information.

      Dr Lam

  • David James says:

    Hi Dr Lam,
    In 2009 nov I was 36 when I woke up one night with excruciating pain in my stomach. Multiple tests and scans reveled nothing. I eliminated gluten and sugar and after 2 years the pain after meals stopped gradually. I had my first inguinal hernia op in 2011 before the pain started to subside. From nov 2011 all was back to normal and I started eating gluten sugar again. March 2014 I had my second inguinal hernia op. July 2014 u woke up one morning with flu like symptoms. I knew it wasn’t the flu though. I couldn’t shake it off for a month and went to physician. Multiple scans and tests revealed nothing. Symptoms got worse each passing day. Severe headache brain fog. Wake up at 3am and cannot sleep. Cannot keep my eyes open all day. Got better after each meal before it got 10 times worse. Couldn’t go to work or drive or do anything. It all seems connected to the adrenals but then I started to get blood in semen after a month after going for a jog. MRI came back with calcified area and diagnosed as prostatitis. No amount of antibiotics or anything else helped. I then started to feel off balance all the time when walking standing sitting. I eliminated gluten sugar wheat yeast dairy soy etc and felt a lot better already. 2 and a half years and 4 MRIs and 2 ct scans later the prostate is still the same. Everytime I put pressure on the pelvic region with some kind of mild sport there is blood in semen. Entire pelvic area gets sore and badly inflamed. Usually takes 6-8 weeks for blood to resolve without any drugs. Please advise on prostate connection if any. Thanks

    • Dr.Lam says:

      Prostate connection is weak if any unless you have other issues going on such as hormone imbalances.

      Dr Lam

      • Anonymous says:

        Thanks Dr Lam.

        I also have recurrent low white blood cell counts where the lymphocytes and neutrophils and platelets are low. Could adrenal fatigue cause this.

  • Jan says:

    I have almost everyone of the symptoms, and I have been telling doctors for years. No one listens, doctors are too busy waiting to see the next patient. Thyroid medicine does not help, it makes me have bad headaches and nausea. I asked them about the adrenal glands and they say take thyroid medicine. I have extremely low blood pressure and some days I feel I cannot take another step from pure exhaustion. I want doctors to understand that they have jobs because people like us exist and get sick. I’m thankful that someone has knowledge about all of this now. I just hope that it can spread so far that it reaches doctors in Texas, and that they begin to listen to their patients. My body is tired, i need rest and rest doesn’t come. I hope your studies and medical information begin to help people. Thanks for publishing the article.

  • Mary says:

    How long can it take for the Heart palpitations at night to get better?

    • Dr.Lam says:

      That is a difficult question because heart palpitation in AFS setting is a symptom that point to underlying autonomic dysfunction. The focus is to fix that and palpitation goes away.

      Dr Lam

  • Andrea says:

    I have struggled with insomnia, stomach issues and constipation for several years now. I am also a type II diabetic. I control my blood sugar with diet and exercise. Doctors find nothing wrong with my stomach after tests and endoscopy. I have a hard time eating a lot of foods that I used to enjoy with no problem and I cannot tolerate most supplements, vitamins and medications. When I talk for more than a few minutes, my throat experiences pain and I usually have to stop talking. I also feel like I cannot catch my breath. It is usually difficult to take a deep breath at any given time. I believe I’m dealing with adrenal fatigue. I have read about foods that will help to heal the adrenals and try to take vitamin C and a good calcium-magnesium with vitamin D when I can tolerate it. I exercise regularly but have not been as aggressive because I’m just worn out. Is there more I can do?

    • Dr.Lam says:

      A sensation of short of breath is a common symptom associated with AFS, but the clinical presentation is more exertion driven and stress driven. If you cannot take a deep breath for no apparent reason, you have to look more into it. Sometimes people describe unable to deep breath wrongly. Also too deep a breath can activate the sympathetic nervous system and make you anxious. We have a lot more history to dig into to find out what is really going on with you.

      Dr Lam

  • Julie L. says:

    Question #3 is stated incorrectly. It should read, “what causes the body to be unable to convert the thyroid hormone T4 to T3?”.

  • Kathy sherman says:

    Is it possible to have both addisons and secondary adrenal insufficiency? I have symptoms of both, very low ACTH, high need for salt, several autoimmune diseases; systemic lupu, Hashimoto thyroiditis, Sjrogens, rheumatoid arthritis, osteoarthritis, etc… the endocrinologists are very confused about what to diagnose me with, originally diagnosed with addisons and on florinef and that helped tremendously then they said my ACTH level was too low and I don’t have addisons but I have a lot of the symptoms of both. Is it possible to have both?

    • Dr.Lam says:

      Adrenal weakness is a continuum. There is much overlap at certain point. A sharp clinician will be able to help you decifer. Many are told they are “borderline”.

      Dr Lam

  • Tina says:

    Thank you for this!

  • Wesley Ramsey says:

    Is taking adrenal glandulars safe without having recent cortisol levels tested? The product I bought has active hormones removed. I go through swings of feeling terrible in times of stress, and then pretty decent sometimes. I’m wondering if I can take this product daily, safely. I have hashimotos, leaky gut and a long history of adrenal fatigue symptoms by the way

  • Paola says:

    Hi Dr Lam,

    I was diagnosed with Hashimotos and I believe I have adrenal fatigue. Is it possible to recover or put into remission both with a Vegan diet?

  • Regan says:

    Are nose bleeds connected with adrenal issues?

  • Max says:

    I’ve had low cortisol on and off with blood work showing it since 2011 andi have had high cortisol on and off since
    2012 . Why are they refusing to give me the salvia test kit that tests four times a day ? And gives a even in depth detail on what cortisol levels are all throughout the day and night

  • Rahul says:

    Hi Dr. Lam… my Blood Cortisol level at 8 AM is 10 (range is 3 to 20). My question is how should I distinguish between adrenal insufficiency and adrenal fatigue. Does ACTH stimulation test will help? My sodium potassium ratio is normal. Most of the time I am out of breath. This thing started 6 years ago after taking Tamiflu tablets, but I had recovered from it in a month time but not to my full stamina. Now again this thing has started I.e shortness of breath, chest CT scans shows that everything is normal. Certain times I also feel hypoglycemic and heart palpitations. one thing is confirmed that this is related to adrenals.

  • Sharon says:

    What about if I have a tumor on one of my adrenals.

  • Eric says:

    I’ve spent the last +5 years working to get diagnosed after being put on statins repeatedly and, at first, nothing happened but gradually and continuously, kept getting more and more fatigued. (Also diagnosed with Type 1 diabetes) First endo suspected cushing because of the shape of my face. Second visit after test results showed elevated ACTH but normal cortisol levels, I said I researched it and I fell into Addison’s (severe adrenal insufficiency) but he immediately dismissed it because I didn’t have the dark skin pigment symptom. 2 endo’s later, repeating a lot of the same conversations, a few visits to ER due to elevated potassium and asking the ER to run tests on aldosterone, the 3rd endo did blood work for renin, aldosterone and antibodies, all positive for autoimmune primary adrenal insufficiency.

    I gave them all the answer up front and they NEVER investigated it which ticks me off! 5 years of my life I’ve lost. My message is you have to be the investigator and push them. They won’t like it but you have to. Things to have them check for: ACTH, cortisol, renin, aldosterone and antiboides (for autoimmune suspicions only as a cause). Maybe also a “suppression test” if you have elevated ACTH to help rule out tumors in the pituitary. “Normal” results usually means they ONLY check for cortisol. Check it repeatedly and check for a trend if it keeps decreasing (ACTH and renin should keep increasing — body telling the adrenals it wants MORE). I took herbal remedies and looking at my timeline graph, it clearly shows a rise in my cortisol while I was taking them. They didn’t fix it, they just delayed & dragged my agony on. Needless to say, the 3rd endo called me directly from his cell phone once he got those complete labs back and prescribed hydrocortisone and fludrocortisone immediately. Finally feeling normal again. Liver tests are coming back “normal”, kidney (creatinine) test results are coming back normal, unexplained retinopathy in the eyes is subsiding, etc. These glands/hormones have a yet to be determined major role in the body’s function.

  • Lesley says:

    It’s amazing how many signs and symptoms are indicative of Adrenal fatigue!

  • Jessica Martin says:

    Dr Lam, I’m a 38 year old once vivacious, attractive, intelligent, successful career woman that started experiencing signs of adrenal fatigue about 5 years ago, only I had no idea what was wrong with me until this August. In July I bottomed out with a temperature of 95.5. I’m sure you know what comes along with that. The end was near. After terrible experiences with conventional medicine ( insistent that i get a hysterectomy, take Prozac and thyroid pills and insistent that a core temp of 96.4 should just be Ignored I moved on due to gut instinct). I found a naturopath who was sure I had severe adrenal exhaustion. I was given high end thyroid and adrenal support supplements and now I’m mostly gluten and sugar free. Overall I’m on the upswing- 25 day periods at 7 days, new hair growth, my brain is working better, less anxiety, less pain etc. However I’ve experienced several alarming crashes. After reading your website (several times to retain information) I’m sure I need additional guidance that my naturopath isn’t experienced enough to help me with on my healing journey. Now that my brain is better the reality of the things I’ve missed out on conserving energy for the must do tasks over the years is almost as painful as the illness itself. I want to be sure that I am taking all the right steps to heal myself as safely as possible. I have a detailed email about my personal struggles the last years including the list of supplements I’m currently on and how often. Can you please tell me how to pay for someone there to read the information in the email and to schedule a phone or Skype consultation with me? I can’t thank you enough for the information on this site. Your research is a true gift to those of us suffering this horribly misunderstood illness. It’s nice to not feel so alone (or crazy).

  • glenda says:

    I have RA/Lupus, sjogrens, macula degeneration, eyc. . So I have many things you listed. I have yet to find any meds to make me feel better. I am searching for help with my sickness. I don’t know where to go from here.

    • Dr.Lam says:

      The conditions you mentioned are specific medical situations that conventional medicine need to attend to. If you are concern with AFS, then reading my book and the many articles is a good start. With as many issues as you have, the best is for you to find a doctor who can put all the pieces for you in a coherent plan of healing.

      Dr Lam

  • Rhonda Glaser says:

    I am positive that there is something occurring with my functions are my autonomic functions I have Nutcracker syndrome AKA left renal vein entrapment syndrome with Lumbar collaterals and ovarian collateral. Just really wish I can find a doctor new what I’m talking about. Experienced or even educated doctor with this disorder are hard to find in Sacramento

  • Aaron says:

    Why would Heavy metal and mineral toxicity may mimic Adrenal Fatigue Syndrome?

    • Dr.Lam says:

      Because both are toxic to the system, and AFS have some, but not all, of the similar symptoms in advanced stages as the body slows down and toxic metabolite accumulates.

      Dr Lam

  • Pam says:

    Dr. Lam- Can you discuss a bit of the science behind the relationship between AFS and chronic pain?
    I am being treated by a great integrative and functional medicine doc, but my pain seems to be increasing not decreasing (possibly related to being more active).
    Also, please discuss any genetic component. My mother, grandmother and 2 siblings all have similar symptoms.

  • Jim says:

    I’ve got all the symptoms, I need help.

  • Lianne Simon says:

    How do you find a doctor willing to actually diagnose a mild adrenal insufficiency? I went to an endocrinologist with a DUTCH test that showed normal 24-hr cortisol but low metabolites. I crash after stress. After surgery, my body dumps electrolytes and my blood pressure plummets. If I don’t eat enough salt, I get severe cramps. I need caffeine in the morning and still slump in the afternoon. I’ve developed a jelly roll low on my abdomen. I’ve gained more than fifteen pounds in the past year. I have central hypothyroidism. My temperature is all over the place. But the endo blew it all off. I’m alive and doing well. I clearly don’t have a full-blow case of Addison’s. So there’s nothing wrong.

  • Lenny says:

    Thank you for taking the time to creat your wonderful website!

  • Anonymous says:

    Please help me i think im suffering from adrenal fatigue…. Is there a treatment?? Im really worried

  • J Chan says:

    Many of the adrenal fatigue symptoms are very similar to low progesterone or estrogen dominance. Would taking progesterone cream along with b6, magnesium, vit C and zinc address both

    • Dr.Lam says:

      Estrogen dominance is closely assocaited but only part of the clinical picture of AFS. symptoms of estrogen dominance can often , but not always , be helped by natural progesterone. In the AFS setting, however , especially in advance stages, the use of progesterone and zinc have to be very careful as they can backfire. Each person is different. Generalalities dont work well and that is why many fail in self navigation.
      Click 7 Adrenal Fatigue Recovery Mistakes for more information.

      Dr Lam

  • Brandon says:

    How can you tell if you have a sensitivity to Electromagnetic forces?

    • Dr.Lam says:

      When you are exposed or near EMG, you have symptoms . They can be subtle, and unless you focus on your body, most people miss it.

      Dr Lam

  • Phil says:

    I seem to have a lot of the symptoms on your list, but how would i be able to know for sure if Adrenal Fatigue is the cause for all my symptoms? Is there any kind of test i can do?

  • Helena says:

    What is the protocol for chronic adrenal fatigue? Where do I start? Detox, herbal support etc. I already do not eat dairy, wheat and have difficulty with fructose.
    I have IBS (C) and have had joint pain.
    I do yoga, mindfulness meditations which help . However, I have a stressful life situation that has created chronic stress.
    I will say I’ve always been foggy in the morning, always was a late night person
    But I am not fatigued through the day. Mornings are difficult however.
    Please advise . Any referral to a practitioner in the Philadelphia area much appreciated.Thank you.

    • Dr.Lam says:

      There is no protocol for AFS because everyone is different. My book gives you a good overall picture on what are the key things to look at . For some people, detox is first, but for others, this can crash them. So everyone needs to be different. That is the challenge. Our appraoch to this issue is unique. Do make sure you avoid these mistakes to start. Click 7 Adrenal Fatigue Recovery Mistakes for more information. We do have a telephone coaching program that for most people will suffice.

      Dr Lam

      Dr Lam

  • Carla says:

    I have fatigue so bad that I feel like I am falling asleep even when I am talking. Is this conected? It seems like I have many of the symptoms you list here

  • Suzie says:

    I am a breast cancer survivor, estrogen + progesteron +. I was put on Anestrazole but the side effects were so bad I was switched to Femara. I have many
    Of these symptoms but that is because the medication is shutting down my adrenal glands. Is there anything I can do to help with these side effects?

    • Dr.Lam says:

      It is common to have side effects from medications ,but whether it is totally due to adrenal issues remains to be determined. Often times its multi factorial and many organs, especially the liver, can also be involved. The first step is to go back to your doctor for advise. If there are no other options but to stay on , then you should support your adrenals without worsening the cancer status. there are ways to do it but the program needs to be planned out carefully and everyone is different.

      Dr Lam

  • Barb says:

    I’ve had increasing symptoms of AF especially past few years w/o diagnosis. Dr.s have diagnosed Fibro & CFS & labs always ‘look good’ otherwise — Dr. thinks I’m ‘hypochondriac’ when I list my debilitating symptoms! I suggested to him “adrenal exhaustion” so he’s referred me to endocrinologist I see in 2 days. Can you suggest the best testing to confirm or eliminate adrenal exhaustion? I’m 70, have Medicare to cover testing and am a proactive patient. Thank you in advance.

    • Dr.Lam says:

      Conventionally trained endocrinologist are not versed in AFS. Do not be surprised if your thesis is rejected. It is good to go thru the work up to make sure it is not anything else. You need to be proactive to educated your doctor on this matter. Click Laboratory Testing for more information. Here are two article you will find useful. Click Why Conventional Medicine Rejects Adrenal Fatigue for more information. Do remember that there is no definitive test to 100% fully “diagnose” AFS at this time as we are still decades away. The key comes down to a good history will clinical correlation that fits.

      Dr Lam.

  • Chad says:

    Can you please explain how someone could have constipation or diarrhea… seems a bit contradictory to risk both. Thanks Dr. Lam!

    • Dr.Lam says:

      The body’s GI track is in a constant state of flux , absorbing nutrients and water etc.This process , on extremes, would lead to diarrhea ( if water absorption is insufficient, for example) , or constipation ( when too much liquid is absorbed, for example). The body self regulates,and the result is well formed stool at the end. This process , when disrupted, can lead to extremes, from one side of the spectrum to another. A common condition called Irritable Bowl Syndrome is associated with such flux. There is no contradiction once you understand the physiology.

      Dr Lam

  • Jennifer Ryan says:

    Hi. I had Cushing’s syndrome and my R adrenal gland and tumor were removed Nov 2015. I had to quit my job as a physical therapist, but have recently started back. I also started swimming laps about a month ago. I am so tired all the time that my LE feel like lead and all I want to do is sleep. I’m only working part time and my cortisol is at a normal level. Are there any supplements I can take to help with the fatigue? I am off cortisol and have been since April.

    • Dr.Lam says:

      With your history, you have to be very careful with supplements, especially those that stimulate the adrenals to avoid any chances of triggering excessive cortisol release. A more complete holistic and comprehensive program requiring detailed history is needed so you dont get into trouble long term. It is easy to give you more energy by stimulating the adrenals, but the pros and cons have to be weighted carefully.
      Click Adrenal Fatigue & Hormone Therapy for more information. Click Adrenal Fatigue Glandular & Herbal Therapy for more information.

      Dr Lam

  • Jude Carrillo says:

    Can adrenal fatigue be the cause of systemic myopathy? Or can it be a contributing factor to symptoms that mimic muscle disease or muscular dystrophy?

    • Dr.Lam says:

      AFS and the illness you mentioned are different. Anytime your adrenals are weak, the body tend to decompensate more.

      Dr Lam

  • Nikki says:

    I never knew that these symptoms were all apart of adrenal fatigue, I have been struggling for so long and looking for answers and no one ever knows. I am so glad I was able to find this article to give me some insight.

  • Laurie says:

    Hi Dr. Lam,
    I attempted to post a few days back but it seems I did something wrong as I don’t see post at this time.
    Short background, I have not felt well for the last few years. I was diagnosed with Ischemic Colitis in Oct of 2012. I attributed all my ailments to this every since, as I didn’t want the surgery that would leave me with “the bag”.
    On Jan 31st this year I was diagnosed with perforated diverticulitis. After making every attempt to avoid surgery on Mar 25th an emergent surgery was performed which has left me with a temp ostomy.
    My last CT was done on June 2nd to attempt to find out why I continue to have no energy, must use sleeping pills, being lightheaded etc…the GI Dr’s office called to tell me there was a “tumor” on my left adrenal gland and this explains why I still feel so bad. They also told me to go to my pcp to get a referral to a endocrinologist and to insist on a biopsy.
    It just happened that I had an appt with my surgeon the following day who informed me the “nodule” had been found in my 2012 CT (first i heard of it) but he didn’t have the current CT report so not sure if any change. He did say I should go to a urologist for further testing but a biopsy was not needed. I should say it is small only 1 and a half centimeters.
    I am uncertain of what is in my best interest. I have 2 qualified Dr’s telling me two different things.
    When my GI first told me this was the cause of my issues I was so happy to have an answer, then my surgeon said basically the opposite which was quite a let down.
    I go to my pcp in 3 days and have no idea which direction she should send me in.
    Some added info….while dealing with my own medical issues since 2012 I lost my mom on my wedding anniversary on September 4th 2014 and then lost my dad on August 14th 2015.
    Sorry this is so long, basically I need some help to help myself.
    I can have resection surgery next Mar or Apr but I must be healthy enough. At this point it takes a focused effort to get out of bed and attempt to get through the day.
    I’m not a lazy person. I want to go back to my job that I worked hard at to become a supervisor, I want the energy to work in my garden my supportive kids planted for me, to be the fun grandma who goes fishing etc…I also want to say I am not 90 , I am 50 years young.
    Do you think this “nodule /tumor” on my left adrenal gland is comprising my quality of life and if so how do I move forward with my medical care?

    • Dr.Lam says:

      That question is outside my area of expetise to answer. However, regardless of which path you take, supporting the adrenals can often be helpful , and if you have not started, it is good to fortify your body right away. If done properly, there is benefit and no harm and your body is well prepared. Do be careful as with your history, a proper program is key. Try not to self navigate if you dont have experience.

      Dr Lam

  • Stephanie Wilson says:

    I have literally about 90% of these symptoms. Do you work on hormones, thyroid,this or what first???
    Currently on thyroid meds, progesterone and
    Numerous vitamins and supplements with very little help!!!

    • Dr.Lam says:

      We need to work on all components, but prioritized properly, because everything needs to be done at the right time and right way for the body to recover properly. Many people use multiple compounds and fail for good reasons. Click 7 Adrenal Fatigue Recovery Mistakes for more information.

      Dr Lam

  • Robert says:

    i have several of these symptoms and about 2 months ago developed the POTS symptoms….heat intolerance….sometimes dizziness if i stand too long….sometime chest pains but e.r says my heart is fine….im really trying to understand how when the pain comes right where my heart is beating ohh and by the way i feel heart palps hmm 24 7….its rarely beating not like a drum….really is seems like overreactive nervous system….right now i just take a good multi vitamin from GNC 50 n older that supports energy brain n heart health its a good one in my eyes also some side vitamins on the side like b12 meth form,and magnesium….and i take a few herbs 3 of them “holy basil,ashwaganda,rhodila rosea”……and try not to do much but rest n take it easy im under the impression ill either get worse or slowly better overtime i have no clue……started n january when my mother passed away then the uncontrolled panic attacks and seems like i have so much adrenaline since ridiculous ive done lots of reading online i think im just gonna leave it at a couple calming herbs good multi vitamin with b vitamins in it and trying to eat well n sleep well idk if much else to do!!

    • Robert says:

      and ive also read so many reasons to why my adrenals are like this….personally i believe its from mother passing because 2 weeks later i started havin problems….that regular docs cant really help but a endocrinologist did test me and my 24 hr cortisol urine came back abnormal but she says i passed the suppression test so she doesnt believe tumor just stress….i hope she isnt wrong smh……i dont even feel stressed anymore as i did in january but i think it takes time i honestly dont kno anymore….ive had so many tests done normal blood x rays its crazy thyroid but i dont think they did the t3 tho….i just know i have high cortisol…..the only thing now is im makin a dental appointment to take care of sum bad teeth in the back ive had for along time trying to rule out anything else and thats the only thing i can think of….when i do go next week i did mention not to use anything with norphinephine i dont think that will be a good idea!!!

      • Robert says:

        one MORE thing i read on this list…..electrolyte imbalance regardless of normal test WUT THE HECK….well how are we suppose to know if we really have a imbalance if the tests are normal thats like the people who have thyroid issues and their test are normal that ive read online…..thats nonsense how do you approach things like this seems impossible!!!

  • lynn marie says:

    I just woke up from another night of bad dreams and heart palpitations. I was finally diagnosed with adrenal fatigue by a bio identical hormone replacement doctor a few months ago with saliva tests after nearly a year of bouncing from doctor to doctor, wearing heart monitors, sleep studies, etc, etc. I am better but still have trouble especially with night time nightmares and heart palpitations. I also enjoy a sport that is stressful and now when I do it I get rapid pulse and an anxiety attack! I am on cortisol in the morning and a cream to lower it at night. I have cut a lot of junk out of my diet and am a high normal BMI. Without a soda I get very tired in the afternoon and my blood pressure gets so low I have to have a soda to perk me back up. I have anxiety and it has made me a bit agoraphobic. Or afraid to travel or get out of my routine. Any suggestions on how I can take my recovery to the next level would be so appreciated.

    • Dr.Lam says:

      We do see a clinical picture like what you are experiencing when the underlying root problem has not be resolved. patching and modulating cortisol with external hormones can only go so far, and while there may be temporary benefit, the overall healing process is incomplete, and deep seated root problem masked. That is why you continue to be troubled and this usually will continue to get worse, leading to potentially more and more hormones in time to come, but ultimately, fails. so it is a warning sign for you to look deeper. The root issues has to be explored, and the only way is by detailed history. ONce the root is exposed and dealt with, you will embark on true complete recovery. BHRT has its limitations. This article may help. Click Adrenal Fatigue & Hormone Therapy for more information.

      Dr Lam

  • jennifer anderson says:

    hi dr. Lam,
    read the list, I have had or have 90% of the symptoms. hashimotos and raised ANA often at 1:640 are the only tests that indicate something is off. seeing a psych and a shrug is what I’ve been getting from my Drs. lately. I’m pretty desperate honestly. along with synthroid, I take adderall ( brain fog, confusion ) cymbalta (joint pain) and neurontin (migraines) could these drugs worsen the exhaustion?
    thank you so much for this site.

  • Ashly says:

    After wondering why I crave salt so much I searched it and came to your site and realized I have almost all of the symptoms listed(now at least i know where they are coming from) but I also have nausea a lot for no apparent reason. Is that a sign of adrenal fatigue as well?

    • Dr.Lam says:

      feeling nauseated is not a common symptom of AFS, though for some people it can happen and it points to underlying issues that need to be explored further.

  • Gayle says:

    I’ve been diagnosed with Addison’s Disease and they never talked to me about how many of my symptoms were attributed to My adrenal insufficiency . I was surprised how many symptoms I have. Thank you.

    • Dr.Lam says:

      Addison’s Disease ( adrenal insufficiency) is different from AFS and requires life long steroid therapy. Sometimes it can be “borderline” and the differentiation becomes blurry. You should talk to your doctor to make sure .

  • Lori Burgan says:

    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?

    • Dr.Lam says:

      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 says:

    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.

  • Deb says:

    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.

    • Dr.Lam says:

      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

  • Kristin says:

    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?

  • Gretchen says:

    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?

    • Dr.Lam says:

      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

  • Sofie says:

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

  • Raphaela Sorkin says:

    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.

    • Dr.Lam says:

      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

  • carmel says:

    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 says:

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

    • Dr.Lam says:

      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.

  • Brandon says:

    Oh and my temperature is lower than usual it has been around 97.7 my usual is 98.6

  • Brandon says:

    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!

  • Emily says:

    Can there be any other reason for my excessive dry skin other then AF?

  • Leanne Pratt says:

    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 🙂

    • Newsletter says:

      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

  • Bruce says:

    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?

  • Laura says:

    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,
    Laura

  • Anonymous says:

    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!

    • Newsletter says:

      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 says:

    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 ?

    • Newsletter says:

      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