No matter what TSH we have, it seems that 50mcg is the usual starting starting dose.
I know a doctor, now deceased, who tried to have a Conference and invited every one of the Endocrinologist to discuss the 'parlous situation' of hypothyroid patients. He was a virologist and came into hypo by chance as he had been asked to see patients who had 'mysterious diseases. What he found was that these people were hypo due to symptoms alone and their TSH wouldn't have been high enough to be diagnosed and being given doses which were too low. The usual dose on NDT was around 200 to 400mcg.
One by one these Endos refused, the last the day before the Conference.
For so doing i.e. diagnosing those who were undiagnosed he was called before the GMC about 7 times because he treated patients on symptoms and each time he was found to be treating them properly. Unfortunately for us he died of a stroke and his staff and patients feel it was due to the immense strain. One of his patient's did a calculation of the 'odds' and it was about 4,000,000 to 1.
One doctor I know always treated adrenals and the doctor above, said that the adrenals would sort themselves out when meds were optimum.
I don't know too much about Adrenal Fatigue but other members will answer if they have info.