Thyroid UK

Chronic adrenal fatigue; low DHEA levels

I have been suffering with chronic adrenal fatigue for over two years now, induced by a ketogenic diet. This was not a gradual manifestation of strange symptoms, I experienced a sudden adrenal crisis that was accelerated by a *very* low carbohydrate intake and an intensive exercise regiment within a time frame of 3-4 days. I experienced a neurological event in my body and immediate blood sugar fluctuations, something I had never suffered with before. A state of fatigue, debilitating brain fog and decreased stamina followed.

Here I am, 27 months later, and still plagued with almost every symptom I experienced during that period, and in probably worse health. These are a list of my symptoms:

- Chronic fatigue, low stamina, excessive sleep.

- Debilitating brain fog and poor cognitive performance.

- Rapid weight gain, particularly around my abdominal area and hips.

- Premature aging.

- Blood sugar fluctuations, hypoglycemia.

- Low sex drive.

- Hair loss.

- Pasty and pale skin texture and tone, and a combination of severe eczema and oily skin.

- Declining dental health, deep cavities and sensitivity.

This is a copy of my recent cortisol saliva test results:

My DHEA levels are relatively low, but this is not necessarily reflected in my abnormal symptoms. I expected it to be lower with some cortisol disturbances. Would supplementing with DHEA be safe and effective? The symptoms listed seem to indicate definite adrenal imbalance.

I'm a male and only in my early 20s, this is clearly distressing and incredibly challenging to resolve. Opinions appreciated.

9 Replies


I had some adrenal issues and tests done so am familiar with cortidol readings - it appears yours are not as bad as you may think. Following a natural curve downhill within ranges throughout the day. However there is some adrenal fatigue and the symptoms are telling. Have you had thyroid checked as well? It's worth getting as much info out on the table first as regarding your symptoms you may find you need to fix gut health (leaky gut and probiotics) alter your diet to eliminate adrenal burn out products like sugar alcohol caffeine and rebuild their energy levels with good greens and bright coloured whole foods and perhaps licourice and borage tincture for eg.

With a full panel of TSH, free t4 and free t3, hormones, liver function, TPO antibodies, iron, vit d, b13 and so forth you can see if anything is not in optimal part of range and work on suppliments first - ie: zinc selenium magnesium vits c d b complex a and e. Omega oils. Or krill oil.

I'm sure if you made all these adjustments to health care for 6 months increased sleep and reduced stress you would feel a lot better.

Asrenak fatigue or burnout is a growing issue yet not fully recognised. One caution is if you get too worried the gp may offer you a Synacthen trst usually done in hospital - which I had to do (shouldn't have) and personally I reacted badly to it.

Not all do but it's rare they establish Addisons disease this is the test for it - and it just forced a major adrenal crisis and thyroid shut down due to its stress test mechanism on the body. I was chronically fatigued and Ill for weeks.

Just a word of caution. It's most likely you are suffering a bit of burn out and will be helped initially a lot by taking a few good steps. Your morning cortidol is good. We all taper off in the eve. But it's worth having a chat about DHEA with an endo. Though make sure what kind of DHEA trst it is with the lab as mine came back high and then they explained it wasn't measureable in a straightforward way. So worth getting their view first.

Hope this helps.



I took a full thyroid panel last year, and found out that my T4 was relatively low. My GP prescribed Levothyroxine and I reacted very badly to the medication. This was definitely not an allergic reaction to its ingredients, it was a reaction to the hormone and an immediate regression to the state I was in when it all started. Extreme cognitive difficulties, fatigue etc. I took it for only a few days and took a few months to recover from the side affects.

The conventional blood tests available on the NHS that I took a few months ago indicated optimal mineral and vitamin levels. I also was on a course of probiotics which cleared up my acne and improved digestion but did not help relieve the fatigue, leading me to suspect that candida or poor gut bacteria is not the cause of my issues.

I've already purchased DHEA as recommended by my practitioner and will see how it goes.


These are optimal results on the Genova test.

Sample 1: optimal was 22.2

Sample 2: optimal was 6.7

Sample 3: optimal was 3.55

Sample 4: optimal was 1.17

So based on that your sample 3 is low.

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Hello mikee5,

I am so sorry to hear of your troubles.

Ate you still medicating on Levothyroxine? Good adrenal function is required for thyroid med conversion and I believe you are right in saying that both glands should be treated at the same time.

Can you post recent thyroid blood test results for members to comment?

When the body is under stress the adrenal glands produce cortisol. When stress is excessive and cortisol runs high, it eventually becomes depleted and pregnenolone is diverted to produce cortisol instead. This is to the detriment of DHEA which is a precursor to the sex hormones and optimal adrenal function exists when the ratio of cortisol to DHEA is 6:1

Your saliva tests show only cortisol samples 3 & 4 and DHEA sample 3 are low in range.

Many people experience this late afternoon low as the adrenals struggle with glycemic control. Although we don't want low range results, late evening cortisol levels should be our lowest of the day anyway and your pattern follows the correct circadian rhythm.

Do you have any high or low blood sugar issues?

I have heard of some people supplementing pregnenolone but wouldn't recommend supplementing this or DHEA without supervision from an experienced practitioner as it is difficult to know if your adrenal issues are a result of a previously undiagnosed failing thyroid gland or if your low DHEA level is resulting from an adrenal disfunction.

mikee5, all endocrine glands have to work in synergy and if you just add DHEA, you could be creating a further in balance somewhere else along the line.

Have you thought of trying adrenal support by way of glandulars or adaptogens?

If I were you I would investigate further for specialised medical help. You are a young man and need advice inorder to get this problem resolved.

If you email she will be able to send you a list of sympathetic endocrinologists that other members have previously found to be helpful.

I wish you lots of luck, flower007


I just wrote a long detailed reply but managed to lose it again. So here is the short snappy version.... (Sorry)

My levels like yours but the second reading was worse (lower). Bought nutri adrenal extra, then went to adrenals forum where they worked out a dosing schedule for cortisone.

Took a short time to feel much better, two years to feel 100%

See my earlier post about temperature graphs.

Xx g


I'm sure this is really obvious but as it's a big factor it my own health, I'll mention it. Do you rely on caffeine at all for energy? If so, even if only small amounts I would strongly suggest going caffeine free. I really miss caffeinated coffee but my health is badly impacted when I consume it. A really healthy alternative is a herbal tea called Yerba Mate. It gives you a slow steady energy and can lift a low mood. It is promoted as incredibly healthy for the whole body including the adrenals. Mine certainly respond very well to it.

Oh and it looks like it's helping me to lose weight too - the opposite effect I have from caffeine!

Hope you feel much better soon x


Hi Mikee, I too went on an extreme VLC/ketogenic and very low calorie at that (about 500 calories a day for over a year). At first it was great, I was dropping weight so rapidly, I was needing to shop for new (smaller) clothes every couple weeks, and I dropped 120 pounds total over about 18 months, getting back to my high school size. But then I started having symptoms of various health problems - eye pressure (glaucoma) issues, herniated discs, and went to doctors, who never bothered to ask me about my diet or check my thyroid or adrenal function but instead kept giving me cortisone shots for the pain I was in (rather than sending me in for an MRI to see if I had a herniated disc, they just told me I had bursitis and kept giving me cortisone shots), and the eye doctors kept giving me beta blocker eye drops to treat the glaucoma, and none of the eye drops ever lowered the eye pressure (because it wasn't really glaucoma, but rather a systemic edema problem caused by adrenal and thyroid imbalances). They even laser-cut my eyeballs to drill drainage holes into them, and that didn't work either. Never occurred to any of these 12 doctors I went to, to check my thyroid or adrenal function, or to question the ramifications of the "treatments" they were giving me.

That was quite a few years ago now, and for all these years since, I've made it my mission to understand what's going on, and to treat myself because the establishment is completely inept. It's years later, and I'm STILL recovering from what was done, between my own decision to eat a paleo/ketogenic/VLCC diet because I THOUGHT it would be healthy, and the medical establishment's complete ignorance about how the body actually works.

I have made progress though, and I want to share with you the things that are working for me.

1. I do take pregnenolone. I take small dosages in the morning, sublingually upon waking. I use Bio Matrix brand, which I get from Amazon, 10 drops (equals about 12 mg) sublingually in the morning before anything else goes into my mouth). If you want to know why I have chosen to take pregnenolone, I'm including a couple of articles, if you want, you can read about it here: and here Based on this information, as well as a whole lot of other research I did on pregnenolone, I decided to give it a try. For me, it helps. I also tried 50 mg tablets daily and did not experience any problems. I agree with Flower that you're best off being monitored if you do take it, unless you are very proficient with self-dosage and monitoring. I agree with that for ANY hormone we take, as hormones are so complex and affect every system of our bodies.

2. I do take DHEA. But I take it in very small dosages, and not every day. I take 5mg DHEA sublingually in the late afternoon, but only if I feel I need it. I can't explain how that feels, it's just something I intuit. Again, I suggest doing more research, making your decision about whether you want to take it based on your findings, and being monitored when taking any hormone.

3. I take progesterone USP. Yes, I'm a woman - however men also need progesterone, even if in smaller amounts than women need. I would have my progesterone and estrogen levels checked even if I were a man because estrogen dominance is not just a women's issue, it's also very common for men. You want to look at the estrogen : progesterone ratio. Suppressed T3 activity means elevated estrogen and progesterone deficiency.

4. Getting to suppressed T3 activity: when you go on a VLCC/ketogenic diet for an extended period of time, your rT3 levels go up. What this means is that your hypothalamus begins to sense starvation and instructs the body to slow down metabolism. This is done by the rT3 mechanism. Even after you begin eating normally (meaning adding calories and carbs back into the body), the rT3 remains high and metabolism (T3 conversion/activity) is still suppressed for a good long time because the hypothalamus needs to be convinced that you are not going to go back into starvation mode. We as a species have evolved (or were created to) SURVIVE. This included long periods of starvation, for which body fat was utilized. The body does not like to give up body fat, and when it has previously been in famine mode, it will hold on to that body fat even at the expense of letting muscle go, because it's the fat that means survival. You have to eat. You have to eat a lot. You have to eat a lot for a long time before the hypothalamus will understand that you are in no danger of being in famine mode again. For more on this, read Matt Stone's book: Diet Recovery: Restoring Hormonal Health, Metabolism, Mood, and Your Relationship with Food (Diet Recovery Series Book 1) - you can download the Kindle version for free, and you don't need a Kindle to read it. This book is life saving, especially for one such as you and me, whose metabolism was damaged by our diets. You'll learn that you must add salt, sugar, starch, saturated fats, calories, calories, and more calories, and reduce water intake. Sounds counter intuitive, and at first it feels draining - like you have even less energy - but that's the way it works, and you raise your energy levels. Calories are the energy source our bodies need - things like adrenal function and thyroid function and reproduction are basically seen as "luxury" functions and easily down-regulated when the hypothalamus suspects famine/starvation. They cannot be "turned back on" until there is sufficient energy provided by way of food. For me, personally, I used salt and food and was able to raise my body temperature (upon waking) from an average of 95.7 degrees to an average 97.1 so far. If I remember to eat salt/sugar before bed, my body temperature upon waking goes up to 98.1. (Fahrenheit, of course, I'm in the US.) You might gain weight. You might gain a lot of it. It's important not to cave to that fear, and just let it be OK if you gain weight. I don't mean to scare you, but I gained 105 pounds in less than a year. The end goal, though, and it works for a lot of people, is that once your body is regulated and officially out of "famine" mode, you can eat anything you want and LOSE weight. That's the way it works. Think of it this way: if your body goes into famine mode from too few carbs and calories, the body will also swing the other way and go into feast mode when there are too many carbs and calories coming in. Again, it seems counter intuitive to those of us who have been brainwashed by the low-fat, low-carb, low-calorie way of thinking. But this is how to recover from starvation. For me personally, I keep gaining weight when I don't eat enough, but when I eat near 4000 calories a day, the weight gain stops and reverses - in other words, I actually begin to lose weight. Ask me how I eat 4000 calories a day? Sadly, I have yet to figure out quite how to do this.

5. You may need to supplement with T3, starting slowly - but this would be done ONLY under the supervision of a doctor who knows what s/he is doing - and not until your adrenals can handle it. I am not personally at this point yet, but that's because I can't get any doctors here to give me any thyroid prescriptions at all. I would (and I did) use salt/sugar/food predominantly for at least six months before considering T3 supplementation.

6. Get your albumin and creatinine levels checked. Low albumin (a form of protein deficiency) indicates hypothyroidism even if all your thyroid blood tests are "normal" (because albumin transports thyroid hormone, among other things) - low albumin is also symptomatic of starvation and inflammation, and high creatinine in the urine indicates hypothyroidism. Ask your doctor to check also your rT3 levels to see if you have euthyroid sick syndrome. Low albumin, high urine creatinine and high rT3 are symptomatic of a VLCC/ketogenic diet.

7. How is your sleep? Are you able to fall asleep quickly and easily at bedtime? Are you able to sleep through the night without waking? Do you have to get up to empty the bladder? How do you feel when you wake up? Is it easy for you to wake up and get out of bed? Or are you experiencing grogginess and a long time to wake up in the mornings?

8. Other supplements I take and could not do without are Thorne Stress-B Complex, Glycine, Proline, Magnesium Glycinate, L-Tyrosine, Thorne Thyrocsin (contains thyroid helping nutrients), Selenium, Tri-Amino (L-Arginine, L-Ornithine, L-Lysine Complex), Turmeric Curcumin at night, Taurine, Undenatured Whey Protein Isolate (Bluebonnet brand, good stuff), Vitamin C, Vitamin D3, Vitamin K2 (MK7), S.O.D. (superoxide dismutase), Grape Seed Extract, Vitamin A, Vitamin E (full spectrum), digestive enzymes & Betaine HCL, NAC, Liver Detoxifier and Regenerator (complex), SAM-e, Methionine, Choline & Inositol, Tulsi (Holy Basil). I do not take anything based on "trendy-ness" or because Dr. Oz or some other perceived shill says it's good, but rather full in-depth research that I do on actual case studies. I take it myself and see how I do. I can't recommend that anyone or everyone else takes the same - just that I take these and they help me a lot, and it would be worth your while to look into them yourself and decide if they are for you.

This is what I've got for you to start with. I hope that my experience is helpful to you and your recovery, and I wish you all the best.


That's a brilliant reply, 1133. I think everyone that is worrying about their weight should read this! Do you mind if I refer people to it when they start talking about low calorie diets?


Greygoose, thanks. Certainly, please feel free. The more people who can benefit from this, the better. Thanks again.

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