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Thyroid UK
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Adrenal fatigue and low cortisol

There r different therapies to treat this issue but it wd be v useful to hear of users experience. What worked or didn't work. How did the user arrive at a treatment that worked for them and what thyroid medication was taken in conjunction. Treating low cortisol/adrenal issues is difficult and there r lots of options, from adrenal adaptogens to hydrocortisone. However much u read, personal experience is invaluable and it wd be so useful to have some feedback. Perhaps it cd be made available as a reference file/archive on the site?

13 Replies

Its a big big subject! Are you volunteering to do the summary document?

First thing is that Adrenal Fatigue is a HUGE misnomer. Adrenal dysfunction would be a better description. In the vast majority of cases the adrenals themselves are working fine, and its the control mechanism that is faulty - for a variety of reasons. That is why docs do the ACTH test, which measures the ability to produce cortisol, and pronounces the patient fine!

Things that have worked for me, in no particular order

1)Magnesium supplementation. Our diets tend to be low to deficient in Mg nowadays, with various estimates as to the number of people low in Mg. You need to take it in quite large amounts, and with it's co-factors, vitamin B6, wholefood vitamin C, a general B vitamin, vitamin A in cod liver oil. I didn't notice any dramatic improvement, but I did notice that I went downhill when I stopped for a while.

2) Ashwaghandha (in the evening) and rhodiola root (in the morning) are useful adaptogens. The really helped regulate my sleep patterns. I haven't tried Holy Basil or Seriphos, but both are supposed to help sleep.

3 Going to bed early, when you start to feel sleepy, rather than waiting for your second wind and then struggling to sleep is a useful technique. Accept that in the early stages you are likely to wake in the night, and possibly be awake for quite a long time. I started off going to be around 9.00, nowadays I can last until 10.30 (I used to be a night owl!)

4) Kick the sugar habit. Once I did it I realised the extent to which sugar had been upsetting my sleep cycle. This means all sweet stuff, you cannot substitute sugar with fruit. And in my case I couldn't use sweeteners either. Kicking sugar out has been a 20 year losing battle. Making sure I eat a high protein breakfast has been part of the battle. A bit of milk on your cereal, or a pot of yoghurt is nowhere near enough. Aim for 25 grams of protein (ie 4 eggs or equivalent) then look at number 5.

5) I have found the Adrenal Reset Diet (book by Dr Alan Christiansen) really very helpful. Before that I was eating paleo, but adding small amounts of strategically chosen carbs has helped sleep, and helped me kick the sugar out. A while back I was also doing intermittent fasting, and then struggling to sleep on fast days. Don't bother, intermittent fasting is for people who have no cortisol issues!

6) As part of the Adrenal Reset Diet you are supposed to use a light box, or get out in the sunshine within an hour of waking in the morning (in England????). I already had a lightbox, but invested in a Valkee which uses light therapy via the ears. I left it behind by mistake when we went away last weekend, so missed 4 days and couldn't understand why I was suddenly so tired! Two days using it again and I was so much brighter!

7) Gluten, kick the gluten. Its effects can be very subtle, and take a long time to show but once you have been off it for a while you will know all about it if you stray from the path of avoidance! For me its not just gluten, but the closely related proteins known collectively as gliadins, which are found in all the seeds of the grass family. And generally eat as clean as you can. Ditch the additives, the preservatives, the flavourings. In fact just ditch the processed food - William Davies suggests that if it has more than five ingredients, or you don't know what any of them are, then it should go back on the shelf. This does mean cooking, and/or learning to cook. But it doesn't need to be difficult.

8) For me a homoeopathic remedy has proved phenomenal. Over the years I have visited homoepaths many times. But only three remedies made a really dramatic difference - all given by different homoeopaths ( and all after I hadn't seen a homoeopath for a few years). But those three changes have been worth it! See a member of the Society of Homoeopaths, but once you have been given a seriously good remedy (sometimes in several stages at different potencies) give it a year or two to really work through.

One of the results of chronic malaise, with no help from doctors is that we become desperate to try anything! Resist the temptation to do everything at once, and give each change at least a fortnight to bed in, and show a benefit or not before making the next change.


Apologies for not replying sooner and thank u for your post. Cd I have a bit of background. How did u find out/suspect u had an adrenal issue. Have u a thyroid issue as well and if so how is this treated.


I just took HC, and it was fine.


Well I thought I had replied to u greygoose but it seems to have disappeared into the ether. Probably due to trying to post on a tiny tablet at 4am. Well will try again. How did u discover u had an adrenal problem. Do u also have a thyroid problem and how is this treated. Did u try other therapies before going on to HC and how did u find them. Have u concerns about adrenal atrophy and will u have to take HC indefinitely?


Wow! A lot of questions! lol And it's a very long story... but I'll do my best to answer.

Well, I didn't discover I had an adrenal problem. I only had a vague idea what an adrenals were. I'd read about them on forums, but no doctor had ever mentioned them. I tried mentioning them to doctors and they appeared to be as vague as I was! But, about 9 years ago, I heard about the great Dr D, in Paris. I took my courage in both hands and got an appt. It was the first thing he said to me on entering his surgery. "Madame, your thyroid is dead, and your adrenals are about to follow it". And he wrote a prescription straight away for HC, and then did the tests, which confirmed his diagnosis. He didn't mess about with other treatments - maybe because he though I was too far gone - just went straight for the HC.

I have Hashi's. I think I've had it most of my life, but I was only diagnosed at the age of 55, and put on Levo. I went rapidly down-hill, developing symptoms I hadn't had before! I saw a succession of endos and doctors, all totally useless, until I learnt about T3 and asked for it. I got a T4/T3 combo, and started to improve slightly. But Dr D insisted I should be on Armour. That was a catastrophy. In the 3/4 years I was taking it, I got so bad I was practically bed-ridden and put on an incredible amount of weight. And, finally, by accident, found myself on T3 only, and the change was nothing short of a miracle! However, it was also necessary to address my nutritional deficiencies - which were many - in order to improve.

No, I'm not concerned about adrenal atrophy because Dr D explained to me that it is necessary to allow the adrenals to work for themselves when they can. You just take HC in the morning and perhaps at lunchtime, but never after 1 pm. That gives them a helping hand during their busiest time, but forces them to work during the rest of the day and night.

No, I Don't think I'll be on it forever. I did come of a few years ago (sorry if I'm vague on time, but the past all just blurrs into on big lump when I think back and I can't work out what happened when. My brain is fried! lol) But, then went through a very stressful period and felt the need to go back on them last year. We'll see how it goes, when I feel strong enough to attempt to wean off them. But I'm quite confident that I will.


Many thanks fr your post. Yr doctor in Paris sounds marvelous but I gather he is hard to see now? Does he have any colleagues/associates that u can recommend. Have seen loads of endos in the UK - all hopeless. Just parted company with the last one who refused to continue with T3 so if u can recommend anyone I'd be grateful.


Sorry, but last I heard he worked alone. His surgery is in his home. I can't afford to see him anymore - besides, getting to Paris is just too difficult for me - my son used to take me in the car, but he's not living with me anymore.

I self-treat now, because I cannot bear the stupidity and ignorance of doctors around here anymore. I'm pretty certain that if I continued to listen to their nonsense, I'd end up punching one on the nose one day! So, I Don't have any recommendations for you, I'm afraid.

On the other hand, if you want to travel, I believe Dr Hertoghe has associates in his practice in Brussels. But there's no guarantee that they're all as good as him.


I take 5-htp, co-enz q10, magnesium and zinc (I have higher night cortisol, zinc lowers it) at night. I take liquorice first thing on waking (this delays the breakdown if cortisol) Then mid morning I take Siberian and panax ginseng with rhodiola rosea. I then take all my b bits and other vits and mins in the afternoon. I take adrenal cortex in the morning and at 1pm. I also take lots of vit c all through the day. I had to stop all this for 3.5weeks for a load of adrenal and pituitary tests and felt much worse. Back in it for the last 4 days and already noticing improvements.

I'm going to introduce pregnenolone further down the line (starting on 2.5mg dose building and watching for signs of over medication to around 30-40mg) I'm still researching into dosage of pregnenolone, but I've read many great things about it.

If this doesn't get me fully functioning again then I'm trying HC.


Thks fr yr post. Cd I ask how u discovered u had an adrenal problem. Have u a thyroid problem and how is this treated. Why r u considering pregnenolone. U say u have read gt things about it. Cd we have details of references u have used. A little background about yr illness wd also be useful.


I have autoimmune thyroiditis (diagnosed in May 2015) and have recently tested positive for Lyme disease (chronic as I was bitten a fair few years ago) I had been suffering from fatigue, weight gain, pins and needles, numbness and nerve pain, slow recovery after exercise, catching every bug going etc.

my endo has prescribed me t3 only which I'm now on and I'm using the t3 circadian method outlined in the book 'recovering with t3' this also helps with low morning cortisol. It's helping but with up and down days.

I've been listening to podcasts by Chris Kesser, Dr Andrew Neville who have mentioned pregnenolone. I've also read books by susan lark and Ray sahelian. It is also mentioned in thyroid: guardian of health and Dr Lams book (which is excellent)

I personally would rather go low and slow rather than hit it with HC before I've tried other methods that are better for my body. Although if they don't work I'm fully prepped to do it. Pregnenolone has no negative feedback loop and takes weeks to work rather than instant. But it is easier on the adrenals. I haven't tried it yet, just read about it. But I know others have had success with it.

I discovered I had an adrenal problem as taking Levo made me feel much worse and left me bedridden in 4 months.


Did u ever have yr adrenals tested? Did u try other meds when u gave up on T4 only therapy? How much T3 r u taking and how much T4 were u on before. I am on T 3 only and doing CT3M too. I am getting guidance from the RWT3 forum on Facebook but I do not feel good on the regime. Cd u provide titles fr the bks u have read. That wd be v useful also if u cd pm the details of thr endo u r seeing. You mention that pregnenolone does not have a feedback loop. Cd you explain what this means and how this is beneficial.

Thank u for posting - there is lot of information out there amongst members and such a wide variety of experiences.


Hi all,really interested in the whole adrenal function issue,I have ME/CFS three years now.Endo found RT3 problem,low DHEA(6...range is 3.4 to 33....said that at 50 years of age I should be 15 anyway),lowish morning cortisol (230 ...range 170 to 530).Been on T3 only a year now and take DHEA ,20mcg of T3 and 25mg of prescription DHEA.Also 200mg CQ10,magnesium,B Complex,minerals,etc..T3 and DHEA have helped considerably,not so much difference with the vitamins.To get more protein in the morning,I bought pea protein powder in a really good health shop,on the recommendation of my physio.Add about 10 to 15mg to juice in the morning with water,makes up about a half litre and drink it while trying to get my body moving.I've really noticed the improvement with that,increased energy and mire stable blood sugars during the day,no big sugar cravings that only makes the situation worse and places more stress on adrenal glands.In the last few months I've been very ill,big flare-ups with joint and muscular pain.My GP agreed to put me on a 2week high dose of prednisone,60mg for 6 days and then tapering down by 5mg per day.It was fantastic..a holiday from ME.2 weeks later I was travelling to London to visit my son,so the GP put me on a six day course of same prednisone because of a very recent burst eardrum and fear of problems with it when flying...again heaven...a lovely time in London with my husband and son,without any fainting episodes,chronic pain or fatigue.My health has improved so much since then.It's so tempting to try hydrocortisone,or is that different to prednisone,but I don't know if my GP would agree,although my Endo might.But I read so many reports about the negative side effects of steroids.Yet what about asthmatics' and people with rheumatoid arthritis who need it regularly.Does anyone else have experience with prednisone or hydrocortisone on a longer term.Can it actually prevent your adrenal glands from producing cortisol naturally.My problems likely stem from severe sexual abuse for many years while growing up,I've spent my adult life dealing with the resulting trauma,and while I'm well,it is always something I will be dealing with.I am currently in year 3 of ongoing police investigations having finally reported to the authorities.It is this which likely brought on the ME almost 3 years ago Any thoughts on steroid treatment would be really welcome.Thanks.


I presume u have a thyroid problem too as u r on T3. Cd u give some details. Hve u ever done an adrenal saliva test. Why did u decide to go T3 only? Have u tried or considered CT3M. I am on this regimen myself but with not great results so far. Have joined T3 only Facebook forum and their admins give u guidance. Cd u pm me with details of yr endo as she/he seems quite enlightened. I have just sacked mine - hopeless. Yes I share yr concerns re steroids. Greygoose seems to have had a positive experience and might be able to offer some advice/reassurance.


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