r/adrenalfatigue

**Hi everyone,**

I have been stuck in a deeply depressed, flat, "asleep brain" state with severe anhedonia, derealization ("fish bowl" feeling), and sudden panic attacks for a long time. Standard SSRIs stopped working a while ago, and I cannot go to shops or restaurants without extreme spatial overload and wanting to flee.

**My Background & Recent Lab Results (Lancet Laboratories South Africa ):**

**Surgical Menopause:** Had a hysterectomy. No blood pressure issues although can be around 140/85 when I’m anxious or higher).
**Fasting Glucose:** 4.9 mmol/L (3.3 - 6.0)
**Fasting Insulin:** 10.5 mIU/L
**Calculated HOMA-IR:** 2.3 (Confirms early insulin resistance)
**hs-CRP:** 9.2 mg/L (High systemic, low-grade inflammation)
**Total Cholesterol:** 6.2 mmol/L (High)
**Morning Cortisol:** 497 nmol/L (Normal reference 185-624)
**D-Dimer:** 0.43 mg/L (Normal)
**DHEA:** 1.5 (Low/depleted)
**Sex Hormones:** Estrogen 58 pg/mL, Progesterone 1.2 ng/mL, Testosterone 37 ng/dL. SHBG 30.30
Ferritin: 48
Saturation 23
Vitamin D 34

**Medication History & Sensitivity:**

**Lexamil (Escitalopram) 10mg:** Currently taking. It completely stopped working for mood and causes severe emotional blunting/apathy.
**Wellbutrin (Bupropion):** Tried recently but was far too activating; triggered severe jittery panic.
**Morphine:** Was on 10ml PRN for physical pain. (7 spine surgeries) Successfully tapered down to 2ml–3ml only on necessary days, but the taper perhaps leaves my nervous system very raw.
**Hormone Trials:** Tried a 3-in-1 compounded BHRT cream (3mg E2 / 30mg P / 6mg T) which made me feel "weird" and aggravated at times. Tried Utrogestan previously (made me deeply flat) and Angeliq (caused rage). I seem to have a severe progesterone/GABA sensitivity exacerbated by my 9.2 CRP inflammation. Tried Estrogel a couple of days ago and it caused a flat/aggravated rebound.
**Xanor (Alprazolam) 0.25mg:** Prescribed for panic, but I rarely use it (only 1/4 or 1/2 tablet) out of fear of mixing it with morphine.
Thyroid: 100mcg Euthrox Daily and 10mg Liothyronine T3
T3 and T4 levels dropped since starting the BHRT cream.
**Current Action Plan Just Started:**

**Metabolic Focus:** Just started Metformin 500mg XR with dinner (tolerating well, no stomach issues) to treat the HOMA-IR 2.3 and lower the 9.2 CRP.
**Hormone Holiday:** Pausing the all-in-one cream permanently since I don't need progesterone post-hysterectomy, and keeping estrogen gel paused until my metabolic inflammation cools down.

**Nutrition:** Eating mostly low-glycemic, anti-inflammatory fats and proteins (mackerel, nuts, berries, cottage cheese) to stabilize my glucose and stop adrenaline surges. Paused fish oil supplements because they caused an acetylcholine-dominance flat feeling.
Has anyone with surgical menopause and high insulin/CRP experienced this level of treatment-resistant anhedonia and panic? Did treating the metabolic root cause (like using Metformin) finally unlock your brain and make you responsive to treatments again? Any advice on navigating the final morphine/Lexamil taper or trying another SSRI or something else ? once stable would be amazing.

Thanks so much. 🙏🏼

Not looking for medical advice just similar experiences:

During a AF crash does anyone else feel like they’ll pass out? I know I have this according to Dr lam…. I already ruled out everything under the sun seeing six different specialists over the last two years and they say my blood work is “perfect.”

I'm not sure what precipitated my adrenal fatigue. Morning cortisol came back as 18 on a blood test, but my blood was drawn at 10:15 AM instead of 8 AM.

I have been on a steady diet of Vitamin B Complex, 1,500 mg/day of Vitamin B5, powdered Vitamin C up to bowel tolerance, L-Glutamine, L-Methionine, Holy Basil, phosphatidylserine, Chromium Picolinate, bovine adrenal complex, potassium, 5,000 IU of Vitamin D, and Valerian for sleep.

The biggest needle mover for me has been hydrocortisone, which I started taking daily around a month ago. I seem to have established tolerance, and I'm trying to find a dose that works for me. Right now, I take 7.5 mg a day at 4-hour intervals.

I'm able to walk and drive, but my legs still hurt when I go up the stairs, and I'm horribly depressed.

In terms of diet, I wear a CGM and have been mostly keto because I get reactive BS spikes. I can tolerate low-glycemic fruits, roasted chickpeas, etc., in small quantities, but if I eat too much, I get a big spike and then a drop. If I don't eat any carbs, I stay low in the 60s - 70s. There's really no way to strike an effective balance.

Have been gluten-free for years, I never cheat on my diet, unfortunately, I'm gaining weight because I can no longer go to the gym or be active, and I have to eat 5x/day. Right now, it feels like I'm getting worse as my body adjusts to the hydrocortisone, but before I started it, I could barely walk. I am hoping I will feel better as I continue titrating the hydro up and listening to my body.

Nicotine is a big problem for me, caffeine less so. I've tried quitting caffeine entirely, but it did not seem to help much after several weeks; notably, this was also before I tried the hydrocortisone.

Biggest symptoms I have right now are inability to concentrate, restless leg during the day because I'm cooped up in my room all day and want to do something but I really can't stomach the activity, depression (obviously, I'm 24 and my entire life has fallen apart), and weight gain.

The hydro seems to even out my energy levels during the day somewhat because I don't get a huge spike at night like I used to, and even that was going away before I started on it. Thyroid is good, testosterone/DHEA are good as well. Had some vitamin deficiencies for B and D, but those should have gone away by now considering how much I take regularly.

My naturopath initially wanted to do Vitamin IVs but she now thinks it could be something besides adrenal fatigue. Dr. Neville does a cookie-cutter protocol and charges AF sufferers like me thousands of dollars for hope, which I think is disgusting and he should probably burn in hell.

I'm planning to start Lexapro at a low dose in a last-ditch effort to regulate my nervous system. If that doesn't work, I guess I'm going back to taking edibles at night because I don't particularly see the point in being sober if I have to sit here, watch myself gain tons of weight, be completely unable to work out, and be depressed and staring at the walls.

The biggest issue I have with this disease is that you'll have 20 people saying this and that was a cure, and 20 more people saying it ruined their entire life. There's no conclusive fix for anything, and whatever you try can make you better or worse, but if you just sit there and lie in bed all day, you'll inevitably get worse unless you take action.

My dad (with no history of mental illness) has developed daily panic attacks, can’t sleep and is going crazy … I am seeking help to find some relief. His blood pressure yeilds ER levels daily and my family is desperate for a solution.

Family medical history: high blood pressure and diabetes

Background: my dad is 59yo and does all the right things (manages stress, sleep, exercise, diet, etc). He never relied on medication to fix something, and instead adjusts his lifestyle or takes vitamins and natural supplements (except blood pressure medication after 55yo). About 5 years ago he started having digestive problems which were never completely resolved and may have pointed towards gall bladder issues. He starts taking a natural root supplement that’s supposed to have gallbladder benefits. He goes to the gym one day like normal and faints as he’s walking up the steps. Still unknown if the episode was linked to the supplement or he was just stressed and dehydrated, but he stopped taking the supplement anyway.

Ever since that day, his body has been stuck in fight or flight as well as digestive issues completely disappearing. He started having the same episodes- ringing in his ears, was dizzy and blood pressure through the roof, visit to the ER, all tests come back normal. He sees general doctors, holistic doctors, psychiatrist, and psychologist with no clear diagnosis. My sister and I have both had panic attacks from general and but this is another level. His panic symptoms were temporarily managed by a strong antihistamine as needed but he developed debilitating back pain. He was prescribed a steroid for the pain which made his panic symptoms worse. The real nightmare started when he abruptly stopped taking the steroid…

His body does not allow him to be tired or sleep more than two hours a night. His nervous system and hormones are completely out of whack. Doctors do not seem to be helping that much other than prescribing endless sleeping pills that do the exact opposite of relax him. One day things point to a nervous system issue another day it points to an adrenal issue. We are lost and my dad can’t function and is exhausted. He will try anything at this point.

I am worried his body is going to give out… He has a completely different personality, I miss him. What is happening.. please help

Been noticing that my heart rate dips below 60bpm every morning, and remains in the 60s throughout the day. I am extremely exhausted and feel like I can't do anything. And all of a sudden at around 10:00pm I feel like I'm good to go, and heart rate is normal around the 75bpm.

I'm wondering if this is cortisol related, before I convince myself I'm having some kind of heart failure.

Just wanted to share my experience to help.
Long post.

Background Pre Adrenal issues:
I was a very active person, played sports my whole life, had a healthy diet. Ran track and played basketball in college, very healthy.

2021: Post COVID my body never seemed to recover and something always felt off. It was mild enough to not go to doctor but I just didn’t feel myself.

2022: SYMPTOMS START TO APPEAR
- Started to develop very bad anxiety. I would be fine sitting at home but anytime I was in social situations or needed to public speak I would damn near have a panic attack. Only time I didn’t have that tight chest anxious feeling was at home and with people I really felt comfortable with, so naturally I started to isolate myself.
- I could sleep 8 hours but it was not restful. Trouble falling asleep. There would be times when I would only sleep 4 hrs a night for 3 days straight but somehow I wouldn’t feel sleepy, just irritable and in a fog.
- Upon waking I would feel okay but around 10 am - 4 pm my eyes would become droopy and glazed over and there would be a fog over my brain. Symptoms would lift at night.
- Became very depressive / suicidal
- Blood sugar problems
- Electrolyte balance problems / Dehydrated symptoms even after lots of water. Chapped lips, red skin etc.
- Caffeine and Alcohol would flare symptoms
- Working out and even walking would flare symptoms
- Gained lots of water weight, face became bloated/ followed by rapid weight loss
- Intense brain fog, memory issues.
- No feeling whatsoever, severe Anhedonia. Anxiety/ fear were only emotions I could really feel. Had no hunger, thirst, happiness , love etc..
This was the symptom that is hardest to deal with I think.

Late 2022: Came to a head when I had what I believe was an adrenal crisis.
Realized I had a cortisol issue due to research of cortisol cycles and when my problems were at worst. Took ashwaghanda to lower cortisol(I thought I had high cortisol). I took it for about a week before it lowered my cortisol to dangerous low levels.
Symptoms deteriorated till about midday when I felt a rush of adrenaline, and became very disoriented. Heart was pounding and face became flush. Felt like I was going to pass out, and there’s no other way to describe it besides it felt like I was going to die quite honestly. Slurred speech when I called my mother to let her know something was wrong. She told me to go to hospital. Scariest moment of my life. Sometimes salt would improve my symptoms so I desperately drank a very salty mix. I drove myself to emergency room somehow. Symptoms became less severe when I got to hospital and the “attack” aspect had vanished though I still felt terrible. Doctor said all my bloodwork was fine except I had slightly low iron. They did no hormone tests and said I was perfectly healthy.
This was a very low point as it was a very traumatic experience and I didn’t know what was wrong with me. And then when I tried to explain it, and what I thought was happening it was not taken seriously. I felt helpless. I went to doctor one more time but still to no avail. I realized that a doctor was not going to do anything that would put them in risk of being sued for malpractice so they would continue to be extremely conservative. And since my symptoms were vague and I didn’t obviously appear ill there was not a rush if you will.
I was going to have to treat myself and that’s what I did.

My protocol:
(Not a doctor, do if you want, blah blah)
First I healed my gut, which is what I think started the ball rolling towards all the issues.
- Cut out Gluten/ Caffeine/ Alcohol(still had on occasion)
- L- Glutamine
- Collagen Peptitdes

After my gut started to heal I felt like I could absorb the nutrients I was intaking.
Supplements Morning:
- Multivitamin
- Magnesium Glycinate X2
- Fish Oil
- B Vitamins
- Taurine
- Licorice Root
- Adrenal Grandular ( used intermittently, sometimes it seemed to help, sometimes it seemed to have no effect if not a negative one)
- Tumeric w black pepper
- NAC
- L Tyrosine ( Sometimes, not always)
- GABA (recently started taking, seems to work extremely well for me)
- Large Glass of water with Salt
- Protein Shake with Collagen (averaged about 2x per week) mainly did it for the Glycine

Supplements Night:
- 2x Magnesium
- 1 x GABA
- 2x L Theanine
- 1 X melatonin

I haven’t had much luck with adaptogens, maybe your body is different.

2022-2026: not to drag it out too much it has been a long recovery with periods of optimism and recovery only to regress later. My job is very stressful so that hasn’t helped and I love sports so I have a hard time not working out. As I write this it is 2026 and I’ve been dealing with it for about 5 years now. I’ve reached a point where I can work out and feel about 85% there.

ADVICE
- Sleep is the most powerful supplement. Try and figure out how to get QUALITY sleep. I got 8 hrs but it wasn’t restful. Use an eye mask, + whatever supplements/ techniques get you into a deep sleep. Your hormones are messed up. Hormones are made in body while sleeping. I realized a lot of my symptoms were simply related to poor sleep. The hormones you need for restful sleep are disrupted with adrenal / HPA axis issues. You need to calm your nervous system for good sleep.
- Stressors delay recovery: Anything that stresses body (caffeine/ Alcohol/ hard work outs) will delay recovery.
- Be consistent! It takes discipline to adhere to the things that help you.
- Dr Lam is a good resource to understanding the science behind what is going on which I will not dip into.

Philosophical / Spiritual Side:
It’s easy for me to preach positivity now that I feel better but for those in the thick of it I know how you feel. Depression/ isolation/ anxiety/ hopelessness of recovery. These are very dark mental states to be in. I’ll be honest I languished in the darkness. I didn’t even try and hide it, I went to the deep end. And it was honestly comforting to express how I felt. I like authenticity and positivity didn’t feel right, because I didn’t see a good outcome. The darkness is where I felt comfortable. I became cold, cynical and isolated. To those that go here I don’t blame you. However, I’ll say that what got me out of the depths was the idea of Hope. That things can get better. Maintaining this outlook is imperative. And it’s not wishful thinking/ they really can.

Criticisms expected:
- that’s a lot of supplements and lots of money
(Both statements are correct, however they are needed)

My 10-Year Battle with Electrolyte Imbalances

For the past ten years, I have struggled with severe electrolyte issues that heavily impacted my muscles. However, it wasn't until about four years ago that I finally realized the root cause was deep mineral depletion. I began supplementing with magnesium, potassium, and calcium, but my body simply could not retain any of it.

In fact, the more magnesium I took, the worse my symptoms became. At the time, I didn't realize that high doses of magnesium were aggressively lowering my sodium levels. Whenever my sodium dropped too low, my body would panic and flush out all the magnesium I had just taken.

Because I misattributed these low-sodium symptoms to low calcium, I remained stuck in a vicious cycle until a year ago, when I began experiencing severe water retention and swelling every time I took magnesium. This was the definitive sign that my sodium was dangerously low, causing my body to aggressively dump potassium. I desperately needed the magnesium—because the moment I stopped taking it, my muscles would lock up tight, and my diaphragm would feel literally paralyzed—but my body lacked the cellular capacity to tolerate or retain it.

The Adrenal Breakthrough

Three months ago, I noticed that taking Vitamin C significantly improved my tolerance to magnesium. This prompted me to dig deeper, leading me to discover the profound connection between the adrenal glands and mineral regulation. I ordered a bovine adrenal cortex supplement, and it was an absolute game-changer. For the first time in my life, taking magnesium didn't wreck my system; I could suddenly tolerate up to 450 mg, whereas before I could barely handle 300 mg and water retention would disappear for some days

Piecing it all together, I realized I have been dealing with severe adrenal fatigue. Looking back at my youth, the patterns fit perfectly: I have always been completely exhausted in the morning, wide awake and "wired" at night, and have battled low energy and a low mood my entire life.

Current Challenges & Experimenting with Adaptogens

While the adrenal cortex and Vitamin C gave me an insane boost of energy, I am still not 100% recovered when it comes to retaining minerals. Occasionally, magnesium will still trigger low sodium, causing my body to flush everything and leaving me with tight muscles again.
To fix this, I recently tried adding adaptogens, but it has been a trial-and-error process:
Rhodila: This made me incredibly fatigued and drained my energy completely, so I stopped taking it.
Cordyceps: I started taking this two days ago, but I am still unsure if it truly suits my system.
I heavily considered trying licorice root because it directly targets my main issue of low sodium, but I am highly hesitant to introduce it since I am already dealing with a severe potassium deficiency.

What adaptogen I can add to my protocol? As seems most people do a few supplements together

My doctor won’t do proper testing as he claims my symptoms not severe

Hi everyone!

This is a post specifically for those of you who suffer from "adrenal fatigue" with low salivary cortisol without being diagnosed with adrenal insufficiency and also take hydrocortisone. How are you benefiting from it? Has it improved your quality of life? More energy? Less brain fog? Less crashes? What dose do you take and do you take it as needed or everyday? Has it caused more problems in the long run?

"Adrenal fatigue" is crippling, and even though steroids can be problematic. HC might be worth it since the quality of life with this condition is very low. Having dealt with pred and dexa in the past I can say they somehow helped a lot with energy but those cant be taken long term. I want something I can at least rely on for days where I may need it. Please share your experiences, thank you!

I have a blood morning of 3.7 (granted this was taken at 11 in the morning and not 8). I can't get ahold of my endo and will probably have to get a new one. In the meantime, what can be done to manage anxiety caused by this? I try and eat every few hours and I think moderate exercise helps after a while, but Idk what else.

Thank you

Well they said I have adrenal fatigue according to my last labs and I got placed on vitex and vitamin C plus sleeping meds.

My whole life I had zero sleep issues and no mental health problems. It all started after a prolonged period of intense stress I couldn't control. One day I had a severe mental breakdown where I felt like the left side of my head was being electrically shocked. At the time I was dealing with intense OCD and panic attacks but paradoxically, those actually stopped after that episode. What started instead was severe insomnia and hypnic jerks: I would wake up less than a minute after falling asleep, sometimes 11–12 times a night, making it virtually impossible to sleep. I only managed to sleep when my body physically shut down from exhaustion.

This happened during my final year at university. After graduation I moved back home with my parents, eliminated all major stressors, and saw a lot of doctors but still can't figure out what's going on. My symptoms still flare up whenever I get even a little stressed, making me unable to fall asleep and putting me on high alert again.

I'd like to ask anyone reading this to look at my symptoms and what I've tried so far, and help me figure out what went wrong and how to fix it.

Symptoms:

Insomnia (unable to sleep for 3–4 days at a time)

Cortisol spike / sudden wake-up right after falling asleep

Hypnic jerks

Gloomy, heavy feeling — unable to fall asleep

Hormonal disruption

Intense panic attacks

Hair loss

Wired but tired

Unable to fall back asleep after waking up

Constant anxiety

Constant sense of impending doom

OCD — stopped after a sudden brain zap during a panic attack (no longer present)

Paradoxical insomnia (sleep state misperception) — occasional

One seizure-like sensation during sleep a couple of days ago

Nerve pressure / pain on the left side of the head

Heart palpitations, especially after oily food

Constant fight-or-flight state

Mania-like symptoms (occurred while only taking Omega-3 and Vitamin D)

What I've tried:

Omega-3 — Helped at first, but after a few days made everything significantly worse than before. Panic attacks and hypnic jerks only fully stopped months after I quit. Cannot tolerate it.

Vitamin D — Same reaction as Omega-3. I cannot tolerate any amount, even though my blood work showed a mild deficiency (level was 20). It gives me intense mania-like symptoms.

Magnesium Bisglycinate — Helps a lot with anxiety, but makes it harder to fall asleep.

Kava root extract — Helped a little, but the effect wore off quickly. Also hard on the liver. Not effective enough to continue.

Ginkgo Biloba — Prescribed by a neurologist. Made my insomnia and wired-but-tired symptoms noticeably worse.

Valerian root (low dose) — Also prescribed by a neurologist. Almost no effect — just a very faint calming sensation.

Emoxypine — Prescribed by a neurologist. Brought back all my original symptoms. They calmed down once the drug wore off and I was able to sleep that day. Never tried it again.

Vitamin B complex (B1, B6, B12) — Felt helpful initially, but blood work showed my B12 went slightly above the upper limit. Eventually started causing vivid nightmares — 3–4 different ones per night. Had to stop. Tried B1 and B6 (P5P form) separately afterward — no noticeable effect.

Nattokinase — Helps with heart palpitations and the nerve pressure on the left side of my head.

Toxic mold test — Came back negative, though I was living in a very old, visibly moldy house when symptoms first started.

Coffee — Makes me feel calm and happy, which is the opposite of what I'd expect. Downside: makes it very hard to fall asleep.

Exercise — Relieves heart palpitations for a while, boosts mood, and helps with sleep.

Cetirizine — Tried it on the suspicion of histamine intolerance. Didn't do much for anxiety, but I felt like my sleep was slightly better.

34, M here

I was told by a doctor to start back lifting weights for 10 mins a day a few times a week, despite adrenal issues.

After a 10 min walk, I went very low and slow but noticed afterwards I swelled up more than usual throughout the day. Is this a sign I should not be lifting weights and adrenals have not healed, or can that improve with consistency given the other benefits of weight training like increased oxygen uptake, more blood to the liver, increased testosterone and muscle mass, lymphatic benefits etc etc

I did not feel tired or wired, but I did experience some brain fog afterwards that decreased throughout the day. We have also been in a heatwave the last week so not sure if that contributes in anyway, but it was roasting before, during and after the 20 min session.

Has anyone experienced similar?

TIA

Hi everyone. I apologize in advance if this is not the right community to ask this question in. Around 4 years ago I gave birth to my first child. After giving birth i started to experience so many unexplained symptoms. A lot of my symptoms seemed consistent with those if high cortisol.

A year ago a took an all day saliva cortisol test and it was elevated all day despite taking it on a day i was super relaxed and stayed in bed all day. All these years ive been to multiple doctors trying to figure out what is causing these issues with no answers. After nonstop vomiting I recently found out i have chronic gallbladder inflammation, stones, and sludge. Does anyone know if an inflamed organ could technically be the cause of consistently high cortisol?

7.6 ug/dL cortisol. Currently on 5 mg of hydrocortisone. Should I hope for recovery?

Previous 6 year use of dexamethasone. Stopped abruptly 40 months ago. On hydrocortisone for the past 7 months.

Severe intolerance to hydrocortisone or any steroid. That is why I have come down from 17.5 mg to 5 mg, while symptoms are still severe.