Thyroid UK
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Adrenal Exhaustion

Hi everyone, I have an appointment this afternoon with my GP.

My latest Adrenal Stress Profile, on the lab report said adrenal exhaustion. My DHEA has also dropped since last year, it was flagged as low in the afternoon.

Do you think my GP will actually do anything to help?

I have rotten symptoms including fainting, extreme heat intolerance, excessive sweating, depression, very dry skin, swollen ankles all the time, as well as all the shaking and feeling sick most of the time.

If she decides to give me HC what is the likely dose?. She told me it was a might last time I saw her. Waking cortisol is lower than last time 3.1 (12-22). My nighttime cortisol has gone up for some reason to 3.6 (1.0-3.0) my insomnia is terrible, I'm sure that's linked.

The weakness has been so bad just short walks have left me breathless and exhausted, I have pain in my feet and legs now since 2005. I've read this can be a connection, so can diarrhoea which I have had for years.

What do you all think? Xx

29 Replies

You will get nothing. NHS does not treat adrenal exhaustion. You must formally have what they call adrenal insufficiency (a step away from full blown Addisons disease)

NHS will not recognise anything else


I thought as much Bluedaffodil. Surely someone who is regularly fainting shows something serious is going on? I just despair. I can see me self medicating for this too.

I've asked to be referred to a good endo in Oxford, I bet that doesn't materialise either. It's just outrageous.

I will keep you posted ;-) xx


I've put a post up Bluedaffodil, I was lucky and have a prescription for 10mg of hydrocortisone!


Hello Helcaster,

I would be very surprised if they treat adrenal Exhaustion - they never acknowledged it in my case.

In my case i did see Dr P first and he confirmed I had Adrenal Exhaustion, then I purchased HC and took things very slowly - it did make a massive difference to me. I hope they give you some but if not their are things you can do, If you didn't want HC, certain herbs, supplements can be very beneficial but that would depend on how serious the problem is. Also their are some great books on Adrenal Fatique - with lots of info to help - in a nutshell you don't have to rely on your doctor to help xx


My doctor helped me and I have a prescription for 10mg of hydrocortisone. I've put a post up about it!


could you please pm website for hydrocortisone tablets.herbal supplements do not help if problem is severe.


Hi Kitten-whiskers, I've gone down the supplements/herbs route but unfortunately my results are worse than last time. My cortisol levels are way under the normal ranges, 17.6 (21-41) I'm not expecting anything, but what is interesting is talking to people who have Addison's. Their symptoms are the same as mine plus I've lost all my underarm and the majority of pubic hair, just like many of them. Why should our symptoms be ignored? I must admit I am hesitant to use HC unsupervised, but agree with you it may be my only option.

I am concerned as my blood glucose has been high but not yet diabetic, as I've read HC can make you risk diabetes. Is that just at higher doses? I just want a very low dose in the morning and see if that helps, but I guess it's a lot more complicated than that! Do you supplement DHEA?


Hello Helcaster,

Dr P said that anything upto 20mg Daily (normally divided over four doses, latest one by about 5:30pm because it can interupt with sleeping) is safe but anything over (unless the body needs it) can cause problems. I was exactly the same, never wanted to take HC unsupervised but in the end I had too, but i did do it very slowly. If the body is lacking then you shouldn't get any problems because you are only replacing what the body would normally make. Once you start to feel better you can cut it back slowly.

I did supplement with DHEA but never really got any benefit (but that was because my DHEA was ok)

A close friend of mine had high blood glucose, she was also told "it was ok" but when she changed surgeries it was picked up on and she was given tablets for it, I would have thought with you being a Thyroid Patient they would take more notice x


Do you think I should split the 10mg I've been given? Not sure how big the tablet will be as it was too late to go to the chemist. It worries me just taking the lot on waking.

My DHEA has fallen and is flagged low in the afternoon. I know there's a breast cancer connection with supplementing it which makes me cautious.

I have to report back in a month, so we'll see how it goes.

I will definitely keep reminding my GP re diabetes.

Thanks! X


Hello Helcaster,

If they are the same as my tablets, they are a reasonable size so a pill cutter will be able to cut the tablet into quarters? Dr P was clear about taking HC four times spread evenly thoughout the day as HC is realised by the body and is at it's highest peak approx four hours before you wake and then naturally fades as the day goes on.

It does seem strange to take it all in one go as it doesn't stay in the body that long.

Dr P has written a book (which can be hired from the library) if you want more peace of mind.

I know it is very difficult and HC has received alot of bad press, but alot of that came from the GP's over prescibing it.

As for DHEA - If it is low then you should have some, especially if you have concerns. DHEA is not expensive (but is not available in the UK anymore) I took DHEA even though my leaves were ok and it never caused a problem, it is not know to cause problems.

Please keep on to your GP if you are worried about Diabetes - sometimes they just need a little nudge xx


I did say to my GP I need to take at least 3 doses, now I know it should be 4! What times do you dose? I told her HC is about a 90 minute half life.

I've just been told on the Addison's site I visit that 10mg is a paediatric dose, so now wondering if I'm going to feel any benefit?

I've read quite a lot online that Dr P has written, but you think his book is worth getting? I really could do with an adrenal bible.

Yes I need to think about getting DHEA it has been flagged as low and hoping this may stop my body hair loss. I think it helps your very dry skin too.

In 4 weeks time I see my GP and I will definitely voice my worries re diabetes. I've already cut carbs drastically, but I have started to crave chocolate again, so need to keep a lid on that. Xx


Good Morning Helcaster,

I take my HC at 7:30am then 10:30, 1:30 & last dose at 4:30.

I took 5mg (when my adrenals were extremely bad) but it made a massive difference - it is important not to rush it, build it up slowly in 5mg increments, please don't rush it - the body needs time to adjust.

Dr P's book you can hire from the library for free ( he has chapters about DHEA as well).

Another book which you may fine helpful (also can be hired from the Library) is called Are you tired and Wired? by Marcelle Pick - this is jam packed with info and I found it very reassuring - she offers what she calls adrenal friendly activities, along with recipes etc.

I am glad you are going to voice your concerns, I never used to and never got any help, now I say what I feel and do go up more often and as a result have received better treatment (need to be selective on what GP to see - they are not all helpful) xx


Hi Kitten Whiskers, thanks for those times, really helpful.

I took HC today and noticed it made me feel really hungry. I also had some diarrhoea, but I have problems with that anyway. I took 5mg at 8am the 2 1/2mg at 12pm and 2 1/2 at 4pm. I'm really hoping it will make a difference. I think the HC causes urine retention? I only passed a really low amount today.

It's good to hear 5mcg really helped you. Did you have any problems with weight gain?

I've been on a medical merrygoround since 1998, so now I'm quite assertive. I try GP's out then stick with the one I get on best with. I have a very complicated history and keeping to one doctor has worked well for me.

Thanks so much for your help! Xxx


Hello Helcaster,

A big clue of Adrenal Fatique is always being hungry, it is important to eat every three to for hours while you are recovering from it. Hydrocortisone caused problems for me, but don't be concerned over that, because I can not tolerate Thyroid medication either.

I think your body will make it clear if you are having too much HC, I know mine did.

Glad you are assertive

Best wishes


The weirdest thing for me is getting hungry within 20 minutes of eating my main meal in the evening!

It does concern me putting weight on as I just managed to lose 2 stones!

We'll see how today goes, I can always take a lower dose if necessary.

I was going to ask if you had to reduce your thyroid meds, because cortisol pushes the T3 in to the cell. What a shame you can't takes them.

I self treat with T3 and NDT but I haven't felt much of an improvement. I know that a drug I have to take for my bladder messes up it's absorption, it also alters liver enzymes :-( I really have no choice but to take it.

Did you have problems with swollen ankles? Mine are very swollen, sometimes all across the front to the other ankle.


Hello Helcaster,

Oh dear you are really going through the mill.

I did get swollen ankles but only when the fibromyalgia was bad. Do you take any Enzyme Q10 that may help, especially as medication is causing issues.

I could only ever take 5mg of HC, anymore caused dreadful symptoms.

I was always hungry, the worse my adrenals were the more I ate, I could quite easy be hungry 20 mins after an evening meal, I used that as a guide to how my adrenals were doing.

II now use Ashwagagandha Tincture and buffered Vitamin C to help the adrenals - the Aswagagandha is great for stress and anxiety.

When I took Thyroid Medication - it would never go in and everytime, however small the dose I would get toxic, I have put this down to my stomach problems, however after years of battling I have finally been given some Liquid T4 (as this is absorbed differently) I was keen to try it, so I am keeping my fingers crossed & thankfully my adrenals are not as bad as they used to be. There are certain things that need to be in place for the medication to work properly.

My weight has remained about the same (within a few pounds) You done great to lose 2 stone - well done.

Do you take any Vitamin E that is supposed to help the cells

Best wishes



Hi Debs, I did used to take Q10, I tried it for leg and foot pain. It didn't help me unfortunately. I've had fibro since 1998, so maybe that's contributing to the swelling. But I honestly think it's because of a fluid imbalance. Salt is supposed to help. I was putting sea salt in my porridge, now I'm worried it may mess up future blood tests. Wouldn't it be great if we could just relax and enjoy life?!

I take 1,000mcg non acid Vitamin C a day to help iron absorption, magnesium helps my muscles and constipation. I was taking zinc and a lot of vitB5, licorice root, ginseng, but my results are still worse :-( I would love to try something for anxiety as this is a real problem for me.

I really hope you do well on liquid T4, I'll read up on it. So it's better if you have low stomach acid for instance?

I think re the steroids your body can tell you if it's too much. I did manage some sleep last night but like millions of others got woken up by the heat and thunderstorm! I have really bad insomnia so I think if I can't sleep at all I'll cut back.

In the past I had a week of 50mg a day of steroids. My doctor was worried about something that can cause blindness and made me take this high dose. I was on the ceiling, I don't think I slept at all most nights. When I went to another doctor I was put on bed rest as my bp was in orbit. So I'm very cautious!

It's so good to hear you've improved your adrenals so much! Xx


Hello Helcaster,

50mg a day, my goodness - what was the doctor thinking? you must have felt awful, no wonder you were put on bed rest. I am very cautious when it comes to docs and their suggestions as I have been on the receiving end when it's gone horribly wrong.

What worked wonders for my Fibro was a nuropfen gel with menthol - it was amazing ( I still use it) You must be under medicated by the sound of it. Have you tried prune Juice? - I used to be prescribed 6 laxatives a day, but now that phase has gone since I stopped the Levo.

Have you tried melatonin to help you sleep and maybe some Lavender oil in an electric burner.

Best wishes



Hi Debs, it wasn't a nice experience! I remember now he thought I had temporal arteritis and you can go blind very quickly. I can understand now why I was bouncing off the ceiling! I'm sure too another nail in the coffin for my adrenals.

Yes I use those gels a lot, my right hip at the moment! They do work really well. I used to go through tubes of it with my painful neck, but that's improved now thank goodness.

I can't eat much fruit, mostly pears and bananas. I have to keep acidity down to help my bladder. I can get away with some fruits like dried apricots though. I used to love prunes in rice pudding. I have had prune juice on the past pre interstitial cystitis and it is delicious. Recently I've found I can get away with a very ripe mango, and it works really well!

I've been thinking of melatonin for some time now. I haven't slept through the night since 1993 when there was a lot of trauma and I lost my home. Although everything is OK now I just can't shake off the extra anxiety. My pattern is sleep at 2-3am then awake by 5 and walking around the house. It's not doing my health any good at all. My best sleep is between 7 and 9. If I miss this I feel terrible. I don't lie in too long, but I can't get to bed at a normal time. One of the reasons I know now is my cortisol is normal, and now on the last test slightly high at midnight. I always get a bit of energy in the evening, which doesn't help!

Have you used melatonin then?

I tried lavender on my pillow, it is relaxing! I'm just very resistant to sleep. My previous GP had to give me a cocktail of drugs including muscle relaxants to get me to sleep. Zopiclone I used once worked on the first night but then I was up again.


Bless, you really are going through it - that is terrible.

Sleep is important for adrenals and knowing that isn't always helpful because you feel you must sleep, you get wound up that you can't and the vicious circle goe's on.

Was the Fibro brought on by your trauma (sorry to hear about that, that must have been devasting) or do you think it is an under medicated thyroid?

I have used Melatonin - it worked really well for a number of months and then just stopped. I did also try a herbal remedy from the chemist and within to days I was deeply depressed, thankfully as soon as I stopped it, I returned to normal.

I wouldn't recommend anything the doc gives out for sleep - they can cause problems.

What I try to do is have a routine - say everynight I go to bed at 10:45pm so before that I will put my electric burner on with either lavender oil or a relaxing blend, do 20 minutes yoga, pop into bed with a blind fold thing on to stop any light near my eyes, that way the body starts to realise it's time to relax and I pop the my MP3 player on with the rainforest or some soothing sounds - this is to drown out any noise.

You have mentioned anxiety a few times - is this a real issue for you? You could try Ashwaganda and Vitamin B supplements, or is it more of a problem than that? My dad is a full blown Anxiety sufferer and he is currently working with the Linden method xx


Hi Kitten-whiskers, sorry this has taken so long, the hospital infection after a hysterectomy seemed to rev everything up for me. I only had pain in my neck before this, immediately after it was like walking through porridge and I could hear my knees crunch with each step. My body pain has been severe since this infection wasn't treated for a month, long story. It set up an inflammatory response that is still getting worse ,16 years later. My inflammation markers are high, ESR 40 and CRP10. No surprises either after the urinary tract infection post surgery caused an incurable inflammatory bladder disease. I lived with a lot of anger for years, as I told staff on the ward I had cystitis and they didn't even send my urine to the lab. Then I was an emergency admission with a haemorrhage sp? 10 days post op where the infection was immediately found. Then I went through many years diagnosed with ME.

The fibro hasn't improved on thyroid meds, but now iron from my GP has brought my temperature up to normal I'm hoping this may help.

Anxiety has been a problem from my childhood, I was a bed wetter until 12, i had abusive parents. I don't think you ever recover, for me bed is a nasty place. I sleep better on the sofa with the TV on, but even this unfortunately has stopped, just wired and tired! We can't afford holidays so there never seems to be an escape from the day to day.

I take a lot of B vits, I even tried 5 HTP for years, I'm just very resistant to sleep. When we lost the house I had a melt down and could only sleep for 10 minutes at a time. My GP had to prescribe a cocktail of drugs for me to sleep.

My bladder has also contributed, in the early days I was peeing every 10 minutes day and night. I'd take a pillow with me to the loo to try and sleep, it was just terrible and the pain is like childbirth. Now I manage things and take drugs for IC I need only get up for the loo 3 times a night unless I have a bladder flare.

I can understand why my adrenals are the way they are!


Helcaster - that is terrible, all you have been through and go through, my heart goes out to you. I am not suprised you are so poorly after your horrible start in life.

I am not suprised you are angry with the docs, how they have treated you is disgusting and you have to suffer that.

I can't imagine all the pain you must be in, I feel bad for complaining about my illnesses after reading all that you go through.

If you have anger that needs to be realised then maybe holosync can work - people swear by it, their is one specally designed for that, I have not got first hand experience of it but it was something recommend by the linden method. Or if you prefer something differen't you could look into Alice Miller - To realise her anger that she had towards her mother she took up unconicous painting - It is very interesting and worked well for someone I know - she was a differen't person after that.

If you couldn't go on holiday, maybe some days out, to get away from the normal surroundings.

Do you think your Fibro is caused by Trauma and not so much the Thyroid - Dr John c Lowe - takes in great length about that.

I hope the HC starts to improve things for you, it was great for me, even though I could only have a small dose, so hopefully it will be for you.

Your bladder problem sounds unbareable - how could they miss that? I have said to my GP about the fact I am always going to the toilet - and I just get a blank look, but if you are getting all that pain, why didn't they do something sooner - I am annoyed on your behalf.

It does sound like you need the meds from the docs to help you sleep - you need some restbite from it all

Best wishes



Hi Debs, you're very kind, I didn't want sympathy just understanding why I don't sleep :-) I haven't taken sleeping tablets since '93, they didn't work for me and to be honest you're even more wide awake when you come off them! If I get really desperate I take gabapentin. I use it for pain relief, but it does shut your mind down as it's also used for epilepsy. These warm nights don't help, I'm sure everyone is sleep deprived at the moment!

I have just gotten used to living with all this, what else can you do? I had a great psychologist in a pain management dept, but beyond that I don't want to open a can of worms, it's too destructive. I now plan my garden and I have a house that needs a complete revamp and repair. I always like to have a project on the go! I choose everything and my poor partner does the work! I've just rescued an abandoned farm cat, she's such a loving little thing and making me very happy.

Trauma isn't good for health as we all know, I'm just hoping the HC can patch me up a bit. After that I have no idea what to do.

Hugs. Xx


Morning Helcaster,

If the adrenals are a problem then the HC will help - you will be surprised the difference it makes.

Cat's are lovely - and to rescue one is fantastic.

My cat is elderly now - 19 now but they make such a difference.

Hope things improve for you :>

Best wishes



Thanks so much Debs. Xx


That is disgusting if they don't treat adrenal fatigue - why ever not? I am about to find out the same after sending off a saliva test and finding I have low morning cortisol too. Someone told me to contact the CCG I can't remember what it stands for now, but it's where you report it if you think your GP isn't doing enough to help you x


I know you have to always jump through loads of hoops. I hope your doctor helps you! Xx


Been through all this myself. Where would you by HC if not prescribed and how much should you take? I have low cortisol across the board, DHEA just about ok so had the spit test in Oct. 2013 been on glandulars and many various vits and minerals and now on Chinese herbs, (helping a bit, early days yet) but as Helcaster wrote, I have all the symptoms of severe adrenal fatigue...still and think I might need HC. My GP and my Endo looked at my spit test and said the way...!


Hi, my GP admitted she didn't know how to interpret the test results so I wrote them up for her with the ranges in brackets. She's taking me seriously now I have had two saliva tests done.

Full blown Addison's patients seem to be on 20-30mg of HC. But I think you should take the lowest amount that helps.

Started the steroids today and my goodness they make you feel hungry. Most patients I've just read on the Addison's site do put on substantial weight. Of course they may just been over medicated. If I start really piling weight on I'll cut the dose.

Dr Myhill I read on her web site say patients with adrenal fatigue usually improve on 5mg of HC. I think it's wise to be very cautious and not start on a bigger dose. Sometimes 6 months of 5mg can rest the adrenals so they heal and patients can be weaned off slowly after 6 months.

I just googled "10mg Hydrocortisone to buy online" and quite a bit came up.


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