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

By: Michael Lam, MD, MPH

Adrenal fatigue recovery is a processRecovery speed from adrenal fatigue 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 recovery from adrenal fatigue is possible. The answer is yes in the vast majority of cases, but only if done right. Adrenal fatigue 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 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 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 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 recovery curve for a normal Adrenal Fatigue recovery

Let us look at this cycle in more detail. The overall 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 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 continuation 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 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 advance adrenal fatigue (stage 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.

Related Post
  Detoxification & Adrenal Fatigue Syndrome - Part 3

Most people have a mistaken belief that the hallmark of a successful 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 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 recovery curves for Adrenal Fatigue

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 2013 Michael Lam, M.D. All Rights Reserved.
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!

Leave a Reply

Your email address will not be published.


  • 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?