[marianco]

Originally Posted by zadok

Cortisol is low normal, so it cant be that....

When a person has a low normal blood cortisol level, Adrenal Fatigue may be suspected.

The problem of using blood tests to determine the presence of Adrenal Fatigue is that the tests are designed for determining the extremes of adrenal function - such as Addison's Disease (where there is near zero cortisol produced) or Cushing's Disease (where there is excessive cortisol produced).

Adrenal fatigue is a deviation from the mean which is not recognized by endocrinologists as an illness because it is not extreme, but which can cause devastating behavioral symptoms and impairment, nonetheless. The signs of Adrenal fatigue are not far from normal - thus a primary care physician may not find anything wrong.

Blood test findings may include (not all may be abnormal - its the pattern that clues us in):
1. low normal cortisol
2. low to low normal DHEA
3. low to low normal progesterone
4. low potassium
5. low sodium
6. low normal blood sugar
7. low normal hemoglobin A1c - with a low normal mean blood sugar

The best test I've found so far is doing a saliva test at least four times in a day for cortisol and DHEA. The saliva test is more sensitive than the blood test for deviations near the mean. Here, adrenal fatigue sticks out like a sore thumb.

In adrenal fatigue, the adrenal glands have not failed - like in Addison's Disease. Rather, then "sputter" - unless severe - where they may sometimes work, and sometimes not.

Other clues to adrenal fatigue (without other illnesses such as diabetes or hypertension):
1. low normal blood pressure (for which a person would receive praise and told they will live long - with the primary care physician totally missing the presence of adrenal fatigue by not doing further investigation).
2. sugar cravings
3. salt cravings
4. fatigue or sleepiness in the late afternoon
5. insomnia
6. occasionally feeling lightheaded when changing position
7. feeling cold often; low body temperature
8. a tendency to tremble, particularly under pressure
9. feeling better after a meal (unless severe)
10. low libido
11. lack of energy - in the morning making it difficult to get out of bed.
12. wanting to sleep in late
13. feeling better when stress is reduced - such as by going on vacation
14. needing coffee or stimulants to function
15. frequent colds
16. PMS symptoms in women
17. depressed or anxious mood, irritability, difficulty handling strress
18. irritable bowel symptoms
19. asthma-like symptoms
20. difficulty in concentrating, impaired memory

Many symptoms of adrenal fatigue are similar to the symptoms of having low testosterone - e.g. low sex drive, depression, fatigue, poor concentration, anxiety, irritability, etc.

One of testosterone's roles is to prevent overdriving the adrenals. It limits the stress response so that stress is not chronic. It reduces pituitary ACTH secretion, which reduces cortisol production. It also directly reduces adrenal gland output, independent of ACTH.

Thus, when a person develops low testosterone (or low progesterone for women), such as with age, he is also susceptible to developing adrenal fatigue.