Treating Adrenal Fatigue in Clinical Practice

Treating Adrenal Fatigue in Clinical Practice

By Dr. Greg Fors – Board Certified Neurologist

Chronic stress is slowly killing your patients. Over time it triggers detrimental effects in their body that will cause chronic disease. It is now estimated as much as 90% of the population is in some degree of adrenal stress. The adrenal glands sitting over the kidneys play a significant role in the body, secreting more than 50 hormones necessary for life. The adrenal glands respond to stress by short-term secretion of norepinephrine, DHEA and cortisol to help navigate a limited stressful event. However, in states of chronic stress high levels of adrenal hormones like adrenaline and cortisol can be generated over time and result in anxiety, insomnia, high blood pressure and even heart attacks and strokes in your patients. I refer to this stage as Adrenal Drive Syndrome; the patient is literally being driven through their day by high levels of norepinephrine and cortisol.

When proper adrenal testing is done through a salivary Adrenal Stress Index Test I find many individuals with unexplained anxiety and insomnia suffer from high states of adrenaline and cortisol output. These patients are stressed and wired. This information helps to properly treat the individual’s anxiety and/or insomnia and prevent future health problems. Numerous studies have shown a connection to elevated cortisol levels and heart disease, Alzheimer’s and many other chronic diseases.

Eventually, your patient’s adrenal glands become fatigued and adrenal hormone production becomes less robust, leading to insufficient hormone levels in epinephrine, cortisol, DHEA or pregnenolone. Hormones that once got your patient up through a normal workday are now insufficient and they begin to struggle. They become stressed and tired. This Adrenal Fatigue Syndrome and its decreased output of adrenal hormones can again be diagnosed with a salivary Adrenal Stress Index Test, available through various laboratories, but more on this later. Adrenal fatigue with low levels of adrenal hormones leads to chronic fatigue, difficulty getting up in the morning, dizziness upon standing, depression, irritability, craving for sugar and caffeine, weight gain and thyroid symptoms that do not respond to thyroid medication. This baffling complex of symptoms often results with individuals being placed unnecessarily on antidepressants and other dangerous medications.

Our modern lifestyle and poor diets are causing this epidemic of Adrenal Drive Syndrome that eventually leads to Adrenal Fatigue Syndrome. Common factors that can affect your adrenal glands include poor diet, smoking, lack of exercise, lack of sleep, overwork, lack of relaxation, chronic pain, chronic illness, surgery, drugs, toxins, allergies and infections. To add insult to injury, most doctors do not understand Adrenal Fatigue Syndrome and therefore fail to run the proper tests to diagnose it. This leaves the unfortunate patient wondering whether their condition is all in their head. How can you tell if your patients have Adrenal Fatigue Syndrome? Do they wake up exhausted after eight hours of sleep, need two cups of coffee to open their eyes, crave sweets or salt, feel depressed, lost interest in sex, keep catching colds, trouble falling asleep, if so they may have adrenal fatigue.

The very best way to know if your patient is suffering with adrenal issues is to have proper laboratory testing done, such as a Salivary Adrenal Stress Index Test. This is an extremely simple inexpensive noninvasive test in which saliva is collected four times a day, (8 AM), noon, evening, (4 PM) and night (best between 11 PM and midnight). Other steroid hormones, such as estrogen, progesterone, DHEAS and testosterone can be measured along with cortisol in the 8 AM saliva sample, if desired. Saliva tests are reliable indicators of the levels of all steroid hormones (cortisol, DHEAS and all sex steroids) in the body. The National Institutes of Health (NIH) and the World Health Organization (WHO), recognize saliva cortisol testing as being very accurate. Some insurance plans also cover saliva cortisol testing. Labs that do a good job in providing this test are Genova Diagnostics, Diagnos-Techs, Alcat and ZRT Labs.

If laboratory testing reveals that your patient’s adrenal glands are not functioning properly, you need to address the problem appropriately. Most patients need dietary changes, hormonal support and co-factor supplements to rebalance the adrenal function. Second, you can support the hormones directly. For example, if DHEA is low, I use a high-level pharmaceutical grade DHEA supplement or DHEA/Pregnenolone combination depending on the individual’s unique needs. If a patient’s cortisol level is low, I supplement with products that contain Adaptogens to support adrenal output.

To address this issue I have designed an ideal adaptogenic formula for Adrenal Fatigue Syndrome called Adapt-Adren. This formula provides specific standardized extracts of the adaptogenic herbs Ashwagandha, Panax ginseng, Eleutherococcus senticosus and Rhodiola Rosea for those who are physically and mentally fatigued due to stress. It features herbs traditionally used to provide overall stress protection, in addition to increased energy and mental clarity. Research has shown that these specific adaptogens aid the body in adapting to the negative effects of stress while promoting overall well-being. These adaptogenic herbs support the adaptive response to stress through their influence on the hypothalamic-pituitary-adrenal axis function.


Directions: As a nutritional supplement for adults, 1 capsule in the morning, can add 1 capsule in the early afternoon if needed or as directed by your Health Care Professional.

Supplement Facts

Serving Size: 1 Capsule Serving Per Container: 60


Recommendations: One capsule in the morning, can add one capsule in the early afternoon if needed or as recommended by your healthcare provider.

Ashwagandha Root Extract (Standardized to a minimum 2.5% total with anolilides) 300 mg

Eleutherococcus Senticosus Root Extract (Standardized to 0.8% eleutherosides B, E and F) 200 mg

Rhodiola Rosea Extract (Standardized to 3% rosavin) 100 mg

Panax Ginseng Root (Standardized to 14% ginsenosides) 100 mg

Other Ingredients: Gelatin and Magnesium Stearate.