Heal your Adrenals with this Easy Program

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Éiriú Eolas (pronounced “AIR-oo OH-lahss”), the amazing scientific stress-control, healing, detoxing and rejuvenation program which is THE KEY that will help you to change your life in a REAL and immediately noticeable way. Available online at eebreathe.com

If you are “adrenals are shot”, then your stress-coping abilities are severely depleted. That is, you’ll just stress out.

Adrenal fatigue can affect anyone who experiences frequent, persistent, or severe mental, emotional or physical stress. It can be a contributing factor in health conditions ranging from allergies to obesity. Despite its prevalence in our modern world, adrenal fatigue is for the most part ignored and misunderstood by the medical community.

The adrenals are located on top of your kidneys and they are responsible for producing noradrenaline and adrenaline which are important for your “fight or flight” acute response. Your adrenals are also responsible for producing steroid hormones from cholesterol, including DHEA, progesterone, estrogen, testosterone and cortisol.

Cortisol has a fundamental role in coping with chronic prolonged stress (psychological, physical or emotional). Cortisol is anti-inflammatory; it increases stamina, boosts mental and physical energy and has a role in your immune/defense system response. It is here where the low fat scam takes its toll. But several things may go wrong other than low cholesterol levels. For instance, your adrenals and your HPA axis might be overstressed or dysfunctional.

The hypothalamus-pituitary-adrenal (HPA) axis is what can be considered the head master of your adrenals. As the name suggests, the HPA axis is composed of the hypothalamus, the pituitary gland (both in the brain), and the adrenal glands.

Our hypothalamus is that part of the brain considered to be the master gland of the endocrine system due to its homeostatic (balance) effect over all our hormonal system.

This is why the HPA axis regulates many functions such as blood pressure, digestion, circadian rhythms, sex drive, body temperature, balance and coordination, heart rate, sweating, water balance, blood sugar levels, adrenal hormones, thyroid hormones and metabolism.

The HPA axis, as the head master overseeing your adrenals, has an effect in your reactions to stress. What is more, chronic stress can suppress the HPA axis, leading to lower production of cortisol by the adrenals.

If there is an imbalance of the HPA axis, it will disrupt your body’s ability to maintain the homeostasis of the hormonal system. Thyroid function may become compromised by any disruption to the HPA axis, so stress can definitely have an effect on thyroid function. A dysfunctional HPA-axis can cause estrogen, testosterone, and progesterone to become imbalanced as well.

If you have leptin resistance due to a high carbohydrate intake, that will make your HPA axis most unhappy as well. Leptin is a major hormone that ultimately influences all other hormones and the functions of the hypothalamus in the brain. Thus, leptin controls the function of the HPA axis. As it happens, it seems that leptin enhances your flight or fight response and it inhibits the secretion of steroid hormones (cortisol) by the adrenals.[1] Thereby it promotes the stress response and it discourages anti-inflammatory effects.

An imbalance in your HPA axis is known to cause symptoms such as muscle or joint pain, dizziness, fatigue, low body temperature, a compromised immune system, constipation or diarrhea, abdominal pain, depression, and less mental acuity.[2]

People with low cortisol levels have a tendency towards allergies, especially hay fever, and the beginnings of arthritis. Low cortisol is associated particularly with autoimmune disorders, such as asthma, arthritis, allergies, ulcerative colitis, and fatigue.

Adrenal Fatigue: The 21st Century Syndrome


Adrenal fatigue refers to the concept of too much stress depleting your adrenals and causing a decrease in the output of adrenal hormones, particularly cortisol. Even though mainstream medicine denies its existence, adrenal fatigue has been called hypoadrenia, neurasthenia, non-Addison’s hypoadrenia, subclinical hypoadrenia, adrenal neurasthenia and so forth.[3]

Low cortisol levels may make you less able to respond when you need to, and it has been associated with low grade, frequent emotional (and sometimes physical) abuse and neglect.[4] There is a strong link between low cortisol and post-traumatic stress disorder (PTSD). Low cortisol has also been associated with a lack of positive good feeling.

Years of poor sleep, excessive stimulants such as coffee, chronic psychological stress (anything from a divorce to an economic collapse without mentioning stressful climate changes…), surgeries, traumatic events, and environmental toxicity can have a very heavy toll in your adrenals.

The adrenals, in their effort to regulate blood sugar extremes from a lifetime of a high carb diet, become overburdened, eventually burning them out.

People can look normal, yet they are living with a general sense of unwellness. People who suffer from adrenal fatigue often have problems regulating their blood sugar, they tend to experience more delayed food allergies, they are more vulnerable to infections and they tend to have pains and mood problems such as anxiety and depression other than sleeping problems. People with frequent respiratory infections, rhinitis, asthma, frequent colds, allergies, fibromyalgia, chronic fatigue syndrome, diabetes, autoimmune disorders tend to have adrenal fatigue. In fact, allergies seem to get worse when there is more stress since cortisol is needed to counteract the inflammatory reactions.

People with adrenal fatigue tend to skip breakfast. They wake up without appetite and the only thing they want is coffee. This has the effect of stimulating their adrenals, extracting the very last juice of them so they can start-up the day. Under more stress, they can faint easily if they skip further meals or just drop exhausted anywhere. So if you are to heal your adrenal function, you must absolutely eat a big fatty breakfast.

Other hormones produced by the adrenals also may leave the ladies prone to more facial hair or acne.

People can crave more salt since the adrenals are also responsible for releasing a hormone related with salt and water. In adrenal fatigue, more sodium is lost than usual, leading to drops in blood pressure, tiredness and lots of salt craving. It is a crime to deprive a person with adrenal fatigue of salt. As it happens, salt has anti-inflammatory effects since it is a natural anti-histaminic. Why do you think it is recommended for sinus congestion?

Since the adrenals produce the rejuvenating steroid hormone DHEA (dehydroepiandrosterone) – precursor for estrogen, progesterone and testosterone – people with adrenal fatigue tend to have bone loss, loss of muscle mass, depression, aching joints, decreased sex drive and so forth.

Another thing often overlooked is that if you are meant to normalize a low thyroid function, you must absolutely heal your adrenals first, otherwise, nothing will happen. Thyroid function often normalizes when you support your adrenals and remove delayed food allergies. Thyroid problems often mean gluten intolerance, and if gluten is removed on time, and you support your adrenals, the damage is reversible.

Adrenal Fatigue Protocol


Adrenal fatigue symptoms and signs include chronic stress, tiredness, excess facial or body hair growth in women, several food sensitivities, multiple chemical sensitivities, hair loss, acne, salt cravings, recurrent infections, low blood pressure, tend to skip breakfast in the morning (lack of appetite and/or drink only coffee), or feeling cold. Keep in mind that you’ll never normalize a low thyroid function (diagnosed either by lab tests or clinical symptoms) if you don’t address adrenal fatigue.

First, try titrating doses of vitamin C since it is a very important nutrient for adrenal function and repair, other than cholesterol. Most folks need only to up their intake of this important nutrient in the form of supplemental vitamin C (most fruits are so loaded in sugar that it makes them useless for the little C that can be obtained from them). For more information on vitamin C, see Heal Thyself with Homemade Liposomal Vitamin C.

Low Dose Hydrocortisone

Dosage as follows[5]:

– Start with 2.5 mg (a quarter of a 10-mg tablet or half of a 5-mg tablet) per day between 6 and 8 am for one week.
– Increase the dose to 5 mg per day between 6 and 8 am if you saw no positive response with the lower dose for one week.
– Increase the dose to 10 mg per day between 6 and 8 am if you saw no positive response with the previous dose for one week
– Maintain your dose of 10 mg in the early morning and add 5 mg at noon if you saw no positive response with the previous dose for one week.
– Maintain your dose of 10 mg in the early morning and 5mg at noon, add 5 mg at 4pm if you saw no positive response with the previous dose for one week.

If at any point you experience carbohydrate cravings, bloating or insomnia, feel hyper, or have any other negative symptoms, either stop or reduce the dose. This is not meant to be a permanent therapy, you can stop this protocol a few days after you feel better, regardless of the dose you were taking. In case of illness or trauma or physical stress, you can take hydrocortisone again with double the dose.

Ask your physician for a hydrocortisone prescription. Most doctors will prescribe therapeutic or  lower doses of cortisone for inflammatory conditions, do they shouldn’t have a problem prescribing such a low dose of hydrocortisone. We are not talking here about therapeutic dosages. This is very important to understand.

Hydrocortisone is the chemical form of the cortisone your adrenal gland produces. The average daily production of hydrocortisone in your body is about 30 to 40 mg. If you have adrenal insufficiency (low adrenal function or adrenal fatigue), you may be producing much less and have symptoms as a consequence. By supplementing your low production with 5 to 20 mg of hydrocortisone, your body’s supply becomes normal and symptoms should promptly disappear.

The misunderstanding with this low dose hydrocortisone protocol stems from the use of high-dose cortisone therapies like prednisone, medrol, etc. With such high doses there are significant side effects such as high blood pressure, osteoporosis, Cushing syndrome, immune supression and so forth. But these effects have absolutely nothing to do with low-dose hydrocortisone treatment. In fact, the reason why most doctors are reluctant to prescribe it is because the dose is way too low in order to make any difference whatsoever. Keep in mind that mainstream science is completely ignorant about adrenal fatigue. The low doses we are talking here is even much lower of what your body normally produces, even if your adrenal’s output of hydrocortisone is normal. High-dose mainstream treatment of cortisone is several times your body’s daily output, that is, 60 to 300 mg of hydrocortisone per day. So if someone tells you that you are crazy for being in cortisone because it has serious side effects, you can reassure them that you are taking below levels of physiological doses of what your body already produces. Remember, it is not prednisone, it is hydrocortisone. 5 mg of hydrocortisone is the same as about 1 mg of prednisone. Fludan.com sells hydrocortisone in powder form which people can then weight with a scale for mg, such as a jewel scale. If you are unable to get a hold of hydrocortisone or experience unsuitable symptoms on it, you can use low dose progesterone cream to support adrenal function.

Keep in mind also that the best test to see if you will benefit from this therapy is the trial one, that is no lab test will be able to tell you with accuracy if your adrenals need a boost. People who have negative tests often benefit from low dose hydrocortisone therapy.

Of course, these are temporary measures. As useful as they may be, they will never replace the need for eating a diet that is most supportive to your body’s physiology and functioning. For more information on a healing diet that will prolong your life and support your adrenals, see Primal Body, Primal Mind by Nora Gedgaudas. Eating animal fats and protein, cutting out on sugar, grains and foods full with anti-nutrients is essential to heal our bodies.


A note of caution

Those with chronic fatigue, recurrent infections and joint pains should keep in mind that iron overload (ask your physician to test for ferritin, transferrin, TIBC and iron) should be ruled out. Ferritin levels should be ideally less than 80 and transferrin saturation should be ideally less than 40%. If you are above those levels, you might want to donate some blood or refer to the Iron Disorders Institute. A great book on the subject is The Elephant Iron by Roberta Crawford. In addition to that, people with iron overload are discouraged from taking vitamin C without proper monitoring.

For an immediate stress-relief breathing and meditation program, check out Éiriú Eolas (pronounced “AIR-oo OH-lahss”), the amazing scientific stress-control, healing, detoxing and rejuvenation program which is THE KEY that will help  you to change your life in a REAL and immediately noticeable way. Full program available online for free at eebreathe.com.



[1] Malendowicz LK, Rucinski M. et al. Leptin and the regulation of the hypothalamic-pituitary-adrenal axis. Int Rev Cytol. 2007;263:63-102.

[2] Rodger H. Murphree. Treating and Beating Fibromyalgia and Chronic Fatigue Syndrome: The Definitive Guide for Patients and Physician. Harrison & Hampton Publishing; 2 edition (January 2003)

[3] James L. Wilson. Adrenal Fatigue: The 21st Century Stress Syndrome. 2001, Smart Publications.

[4] Sue Gerhardt. Why Love Matters: How Affection Shapes a Baby’s Brain.Routledge; 1 edition (24 Jun 2004)

[5] Sidney MacDonald Baker. Detoxification and Healing: The Key to Optimal Health. McGraw-Hill; 2 edition (August 27, 2003)

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  1. Mary Jane Marsh  November 19, 2013

    Wow. what a wonderful article that has so much help offered in it. I am battling with hypothyroid-adrenal issues. How wonderful of you to share this information. When I think of all the suffering the people are going through, me included currently, I am in awe of someone like you who is willing to just put the information out there for anyone to research for themselves and to try. You are a true healer not just a doctor (although I admire your scientific mind that has chosen to study the human body)

    Now I have to find a doctor who will order hydrocortisone, because mine will probably not……and I do know that my adrenals need help. Thank you so much. Mary Jane

    • Gabriela Segura, MD  November 20, 2013

      I’m glad you found it useful. I hope you find an open minded physician. The dose is so negligible that I will find it surprising if someone will refuse to prescribe it. Another alternative is adrenal cortex supplements (not the medulla) which can be found over the counter. I hope your adrenals get much needed support. Best!

      • Nature heals  February 14, 2015

        I went to two doctors explained my condition, they thought I was crazy wanting hydrocortisone, I said well what I really want is to get better, and you are no help so
        I’m going through the rule out process. I ended up ordering my hydrocortisone from
        An international online pharmacy. It arrived and was in the foil line packets, this is the same
        Way I had to get Armour Thyroid.

        Now, I refuse to go to a doctor, if there was one like you, I would be first in line but you
        Are 1 in a million.

        I’m learning so much from every article. I have done so many of these things, the liposmal Vit. C, the hydrocortisone, DMSO, hydrogen peroxide, but I haven’t had a luck, so I really
        Think I haven’t cleaned out a very clogged colon & intestinal cleanse, followed by good bacteria, & a liver, kidney & gallbladder cleanse, then I think after all that I will start the keyogenic diet and add the supplements I know I need.

      • Gabriela Segura, MD  February 14, 2015

        Yeah, dietary changes are really the pillar, everything else is pretty much complementary. For some great info and testimonials, you can check out Maria Emmerich’s book “Ketoadapted”. When our modern food is so toxic, eating and doing what is most anti-inflammatory will help us heal.

  2. Michael  May 6, 2014


    On the site of Fludan, there are two types of hydrocortisone (acetate and microionized). Wich is the best ?

    Another question ; is adrenal cortex suppléments and hydrocortisone the same ?


    • Gabriela Segura, MD  May 6, 2014

      Folks usually get micronized, but since you need a scale that weights in milligrams (i.e. precious stone scale), it is best to opt for the most practical thing at first. The adrenal cortex is not the same and can be bought online. It comes in capsules and there are instructions on the label.

      • Michael  May 7, 2014

        So it is better to opt for the “acetate” form?

      • Gabriela Segura, MD  May 7, 2014

        I would give the adrenal cortex a try first. Sometimes it is more than enough and what your adrenals need.

  3. Michael  May 7, 2014

    Anyway, before the precrire Cortef, my doctor gave me a blood test to check cortisol at 8am.
    I wanted your opinion on this test. Do you think it is a reliable test for adrenal fatigue?
    thank you

  4. Jennifer  May 7, 2014

    Thanks for all the information. It is so hard finding the right information online for adrenal issues. I experienced a few major life changes all at once, and have been battling with very low energy and other issues for the past 2 years. I think things are starting to stabilize, and I tried the hydrocortisone test at 2.5 mg in the morning. I am not sure, but I think I saw some minor success with it–I stopped it after a week, as I did start craving carbs, but I think I am always craving carbs, to some degree. I try to eat primal as much as possible, eat a couple of eggs and some meat every morning, or nuts and some fruit. I am wondering if I should try the hydrocortisone again and see if it can increase my energy level more and stop the other issues–very slow weight loss(still need to take off 10 more pounds, took over a year to lose 12 with diet and exercise), acne that has just started, always cold body temperature and recurrent infections. Any advice on the hydrocortisone? I also have used Raw Adrenal Grandular by Natrual Sources in the past, but I wanted to try one path first before I move on and try another.

    • Gabriela Segura, MD  May 7, 2014

      Hi Jennifer! Maybe you should do the ketogenic diet: paleo low carb version with lots of fats. There is a nice book called “Ketoadapted” by Maria Emmerich if you want to look into it. I’m sure it will help you health and weight-wise. As for hydrocortisone, you can always try it again to see it helps. L-glutamine is great for carb cravings, if you get a powder version, you can put it underneath your tongue every time you crave sugar. It has also great healing properties. Best!

  5. cristina algota  May 24, 2014

    Quiero suscribirme a tu blog pero no sé por qué motivo el sistema no me lo permite, me da error.
    Me suscribes, por favor?

    • Gabriela Segura, MD  May 24, 2014

      Listo Cristina. Gracias por el interés! Espero lanzar pronto un nuevo formato de este sitio web que incluirá su sección en español. Mantente sintonizada. Un caluroso saludo!!

  6. Denise Hartling  May 25, 2014

    Loved your article on adrenals. I have severe systemic candida and holistic doctor does not want to treat adrenals or thyroid because the underlying cause is candida and leaky gut. However, my adrenals are shot and I don’t need a test to tell me that. Also have elevated thyroid antibodies. Should I support the adrenals in the interim? There is controversy about cortisone feeding candida so I am really torn about what to do. My weight has dropped from 108 lbs to 81 lbs (4 FT, 11 inches) because of malabsorption. Thoughts?

  7. Johnny  July 13, 2014

    Hi. I have an overactive thyroid, I get hot quickly all the time but I’m on the ketogenic diet. Could you recommend a supplement? I know iodine could make it worse and I’m unsure of a thyroid supplement.

    • Gabriela Segura, MD  July 14, 2014

      I would be patient and let the ketogenic diet do its work. You could try supplements such as taurine and magnesium to help with the relaxing system.

  8. Johnny  July 14, 2014

    Thanks for the swift reply Dr Segura! I have homemade magnesium oil but I think I’ll have to up the dosage or use it more frequently than I do. Or add the mag capsules that I was taking before for a quicker effect, though I don’t like taking too many pills. I’ll definitely look at the taurine. Thanks again.

  9. Anna Simmonds  July 20, 2014

    My mother has been suffering with feeling very low to experiencing acute depression for the last 6 years. She met with Professor Jane Plant in London (author of a book about overcoming anxiety and depression) some years back who from what I understand diagnosed that her adrenals were not functioning properly and who I believe recommended hydrocortisone. She was prescribed these last summer and felt much better – they are not readily available to her from local doctors in Sweden so she has managed to get them prescribed from Norway. She is currently taking these again following a terrible bout of depression this past winter and says she finally feels much better. However, in the mornings she still suffers from what sounds like anxiety attacks (which she has been suffering with for several years now) as soon as she wakes up in the morning. These daily debilitating “anxiety attacks” can take a couple of hours to subside. Is this something you are familiar with? Are you able to offer some advise on what course of treatment she could follow?

    • Gabriela Segura, MD  July 20, 2014

      The answer is not simple Anna, but I will encourage you and your mother to do some further research on it. It is practically impossible to have good mental health just as long as dietary changes are not addressed. It also helps enormously to have a tool to work out anxiety feelings. I suggest you check out:

      “Primal Body, Primal Mind” by Nora Gedgaudas
      Éiriú Eolas meditation and breathing program available at eebreathe.com

      Both are good starting points for crucial info that will change your life.

      All the best!

      • Anna Simmonds  July 21, 2014

        Thank you! I have ordered the book you have recommended.

    • In desperate need of help!  February 4, 2015

      Hey Anna! I’m from Sweden and in desperate need of hydrocortisone(my adrenals are messed up, confirmed by saliva cortisol test). Where did your mother go to get help? Was it balderklinikken in Norway?

      If you see this, I would do anything for an answer, please help me.

      • Anna Simmonds  February 4, 2015

        Hi. Yes it was the Balderklinniken where she managed to get the adrenal cortex from. Since then though she has managed to buy them from a health shop called NH2 in Gothenburg (Lineplatsen) which is much more affordable obviously. Their website is http://www.h2.se. The lady who works there has been extremely helpful.

        My mother would be more than happy to talk to you. If you think you would find this helpful then you can perhaps forward me your email address via Gabriela’s contact on her website and I can then forward you my mother’s telephone number.

      • Anna Simmonds  February 4, 2015

        Sorry I just noticed I wrote the website address down incorrect. It should read http://www.nh2.se and the shop’s telephone number (Gothenburg) is 031 138488.

    • In desperate need of help!  February 4, 2015

      I can’t reply to your other posts for some reason so I’ll have to reply here. I didn’t really get what you mean with forwarding my email via her contact site so I’ll just put it here(it’s not my real name or anything so it’s ok): janne4954@gmail.com

  10. Karl Casias  August 19, 2014

    First off I would like to thank you for this site and all the info.I am male 53 years old,really good physical condition[bp,bs,all check out]have episodes of verieing degrees of insomonis,anxiety,mild depression,racing mind waking at 1:30-2:30 a.m with kind of hot flash anxiety and poor sleep from then on.Have had some strong stress episodes in the past Divorce,move to a new town,relainshoinship problems with my kids.At home tests with BP from lying down to standing shows no change[sign of underactive adrenals?Anyway brain fog, fatigue,unable to nap without feelings of anxiety/mild deprewssion upon awakening.Had sleep studies,Blood sugars,all check out well doctors just want to prescribe anti deppressents[ [wont take] seems like a cortisol issue but not sure.Any suggestions would be greatly appreciated.Iron was good according to doc on last visit.May God bless your work for many many years. Karl

    • Gabriela Segura, MD  August 19, 2014

      Hello Karl, the problem has probably several different factors. I would start by changing the way you eat. Believe me, that is the best favor you can do yourself now. Check out https://www.health-matrix.net/2013/08/09/the-ketogenic-diet-an-overview/

      For more information, see Maria Emmerich’s book “Keto-adapted”. Do the breathing exercises suggested in this article. A good book to approach emotional factors would be Gabor Maté’s “When the body says no”. You could try supplementation like the one suggested in this article, but pipe breathing and changing how you eat is the way to go. In order to achieve a restorative sleep, you can try with melatonin or 5 HTP. I wrote a short article on the later one here:

      Boosting Your Happy Brain Chemistry with 5-HTP

      All the best!

  11. Gabriela Sanchez  August 20, 2014

    Thank you for this article, really informative. I have just recently been diagnosed with adrenal fatigue, this is totally new to me. I have hypothyroid as well and doctor has checked my thyroid levels he says I am fine although I have some cysts but biopsy revealed they’re not malignant which is really scary because my grandmother has thyroid cancer.
    I have been on hydro cortisone for about ten days already, I see no change at all yet. Should I need to make a phone call to my doctor or do I need to give it more time? thanks for your help

    • Gabriela Segura, MD  August 20, 2014

      Hello Gabriela! I would call your doc, yes. As you can see, you can increase the dose and most people start with a generous dose (but still low dose hydrocortisone) when first starting. It is advised to start with the lowest, but depending on your symptoms this becomes relative.

      I hope you are making (or did) dietary changes. Gluten must be completely avoided if you have thyroid problems. This includes ALL grains and their derivatives. The gluten-free industry has even more toxic foods. Paleo is probably the best diet for you right now. Take care and hope you recover your health.

  12. bernadette  September 25, 2014

    Thank you for your article. I am just wondering: with my cortisol saliva test, would this warrant the use of Hydrocortisone or Adrenal cortex by Thorne. I found a dr to treat me with my adrenal problem. However he thinks that my levels are normal enough. Pls let me know your thoughts. Thank you so much!!

    6.1- ng/mL 3.7-9.5 (morning)

    1.7 ng/mL 1.2-3.0 (noon)

    1.1 ng/mL 0.6-1.9 (evening)

    0.4 ng/mL 0.4-1.0 (night)

    • Gabriela Segura, MD  September 25, 2014

      Hello Bernadette!

      I think clinical symptoms is the best guidance, and so is response to therapy. I don’t trust completely trust lab tests. You can try a small course of low dose cortisol and see how it goes. Remember, the best way to address energy levels is through dietary changes, see low carb/keto diet and/or gluten-free paleo diet. All the best!

  13. Nanci  October 18, 2014

    hi Dr. Segura,

    how do you treat a very low cortisol in the AM but a very high cortisol in the afternoon and then lowish and then slightly high at night?

    I’ve tried HC but it makes me so jittery and more anxious than I already am. my b/p pressure rises to dangerous levels. My doctor is very heavy handed when it comes to HC. he thinks its the panacea for treating everything.
    I am taking adaptogens like holy basil, ashwagandha to help lower the highs which I hear if you treat the highs, the lows will increase. is that true?

    I am at my wit’s end with high anxiety and the jitters. I lost my sense of smell and taste from a cold in August and it never came back. the last time this happened, I ended up on benzos and went through a horrible withdrawal taper.

    any advice on this? Thanks so much.

  14. Roxanne  October 18, 2014

    Hi, I was diagnosed with central serous chorioretinopathy in 2011. It resolved within 3 months. The specialist said that it is mainly due to high cortisol levels related to leading a stressful life. I slowed down a bit and it helped. No one had considered to check my cortisol levels back then. I recently had bloods checked for iron, thyroid, cholesterol and blood sugar, everything was fine and only found out Vit D deficiency. I have been on supplements since then, but still feel unwell and still gaining weight noticing it more in the misdection despite efforts to control calorie intake and exercise. Last year there was grief in the family and I can feel that My stress management is unsatisfactory since then. I feel that am suffering from Adrenal Fatigue as I have most of these symptoms described at the top. Thank you for the article it seems that this explains it all. I will let my Doctor know about this.

    • Gabriela Segura, MD  October 19, 2014

      Hello Roxanne,

      If you haven’t done dietary changes, I highly recommend them. There are certain foods in our mainstream dietary guidelines that are simply deadly in the long run, certainly they compound any problem due to their inflammatory properties. There is great material out there, but you can check out “Ketoadapted” by Maria Emmerich. It is not about caloric restriction, but choosing what is most physiological for your body’s needs. Wish you all the best in your health journey!

  15. Jodie  October 25, 2014


    I am going to the doctor soon and am wondering what type of blood tests I should have done to check on any deficiencies my body may have.

    Thank you,


    • Gabriela Segura, MD  October 26, 2014

      Hello Jodie,

      Other than standard tests such as hemogram, coagulation tests, liver and kidney function tests, electrolytes, cholesterol, thyroid function… I would add inflammatory markers such as C reactive protein and iron overload markers (TIBC, iron, ferritin, transferrin). Iron overload is often manifested as fatigue and it is important to rule this out. I don’t overvalue hormonal tests, unless results suggest specific organic pathology. Clinical symptoms are often the best guidance for adrenal fatigue. All the best!

  16. Jill  January 5, 2015

    Hello, I have suffered from a mysterious debilitating illness for about 45 years now, which comes and goes with severe periods and not so severe periods, having been diagnosed with ME, CFS, Fibromyalgia, and now Lyme disease (I was bitten by a tick in my teens, and have had rashes on and off) all my symptoms fit with the above. Throughout my life I have been subjected to enormous emotional stress and I am now wondering, having read your article , if adrenal exhaustion is at the root of my problems. The last bout has lasted 2 years and has been so severe it’s left me burnt out. Also I am having problems with my vision, and have increased facial hair too, which is not a problem ever experienced before and deeply upsetting. My GP is no use at all. I have been a vegetarian for the last 25 years, and now eat fish as well. I can’t follow a meaty diet, please can you give me some helpful suggestions ?

    • Gabriela Segura, MD  January 5, 2015

      Hello Jill,

      I’m sorry to read about your struggle. It might help to take some adrenal support in the form of adrenal cortex, French oak wood extract or any other mentioned in this article. But I think that changing your diet is the single most useful thing you can do to improve your health. Do read “The Vegetarian Myth” by former life-long vegetarian Lierre Keith. She sums up the research including the ethical part, and what vegetarianism did to her health pretty well. Although she deals with irreversible damage, she improved her health a great deal since changing her diet. Apple cider vinegar, digestive enzymes and betaine HCl are among the supplements you can use to help you transition. At least start by eating some organic eggs, that alone can help a lot.

      Hope this helps!

      • Jill  January 5, 2015

        Thank you for your advice, I am already taking apple cider vinegar (with the mother), digestive enzymes, and HCl , and a supplement to heal leaky gut also Samento which were all recommended by a kinesiologist I saw recently who diagnosed the Lyme. So it seems I am on the right track.
        I am not vegan, so have always eaten eggs, organic where possible, and eaten fish too for the last 5 years.
        I have read the reviews of the Vegetarian Myth, it sounds interesting, but I cannot foresee a time when I would feel able to eat meat, not just for ethical reasons, but I simply can’t stand the look and smell of the stuff ! However, I am bumping up the quantity of eggs and fish and taking a pea protein supplement. I should add that I have been ill since I was 13, and only became a vegetarian at the age of 30, at which point I felt better, rather than worse as I was unable to digest animal products. Being gluten-free seems to be helping greatly too.

  17. William  January 10, 2015

    Will Hydrocortisone cream produce any results? We hear so much about Transdermal products.
    Thank You.

    • Gabriela Segura, MD  January 10, 2015

      It should, yes. My experience with progesterone cream has been excellent. Transdermal products do work.

      • William  January 12, 2015

        Would it be OK to mix Hydrocortisone cream with DMSO to help with absorbtion. In your opinion what would be the best way to use?

        Thank You.

      • Gabriela Segura, MD  January 12, 2015

        I would use only the first one. DMSO can potentiate drug effects as well. It is something you can experiment eventually, depending on how things go. Best.

  18. Gregg  January 10, 2015

    I have been suffering from adrenal fatigue for about a year now. I am 59 and was an avid power lifter. It all started when I started to get hypoglycemic daily especially during cardio. Very tired the next day as well. Lifting to much combined with the mental stress from my job did me in.
    I have been managing the hypoglycemia by eating good foods every two hours. But I’m still not myself. I’ve tried all the herbs and vitamin C but still am not well enough to resume my strength and cardio routines. Should I try the Low Dose Hydrocortisone? If so how much and how long? Thanks.

  19. Guy  March 29, 2015

    I took hydrocortisone to heal severe adrenal fatigue with hypoglycemia at night.

    But I don’t know why I stopped. I guess I thought it was heal. I lived 2 weeks normally but then hypoglycemia during the night again so I took 0,7 mg of hydrocortisone at 8am and it was awful.

    I felt like I had too much stress, I almost had a vasovagal episode, my heart beat hyper fast.

    A few hours later I felt ok but when it comes to sleep at night, it was impossible and it was not hypoglycemia but too much cortisol.

    Now my body produce too much cortisol (specially during the night) while I have adrenal fatigue. So I can’t sleep anymore since 1 week. I am in panic I don’t know what to do. Moreover I’m all alone in this situation, nobody understand.

    I read about “stage two of adrenal fatigue”, the resistance phase, where the release of cortisol remains excessively high to cope with perceived demands. Sleep is not good at this stage.

    So is it possible that when I took only 0,7 mg HC I put myself from “crash stage” to “resistance phase” ?

    What am I suppose to do ? I wait to go back to “crash stage” with hypoglycemia or I try to take 2.5mg HC to help my adrenals ?

    But I’m very scared that despite my adrenal fatigue I produce too much cortisol and if I take 2,5 mg I’m going to have very bad side effect like vasovagal episode or worse.

    I feel trapped, please help me.

    ps: I am followed by Endocrinologist but he knows nothing about adrenal fatigue. All the Endocrinologists that I saw say adrenal fatigue don’t exist, for them there is only Addison’s disease.

    • Gabriela Segura, MD  March 29, 2015

      Hello Guy,

      Changing your diet in order to avoid “the fight or flight” response that comes from spikes and lows in blood sugar levels is the way to go. I highly recommend you read “Primal body, Primal mind” by Nora Gedgaudas for some insights as to which foods are highly toxic for your adrenals and health in general. She also gives excellent supplement recommendations that will help you achieve a good night sleep. You could try these days some 0.25mg -0.5 mg of melatonin to see if you restore your sleep cycle. Best!

  20. Guy  March 29, 2015

    Thank you so much for your fast answer.

    I take melatonine since yesterday. It makes me sleep but 3 hours later I wake up and impossible to sleep again.

    What do you think about the resistance phase, where the release of cortisol remains excessively high ? Is it possible that I am here ?

    Why did I have such strong effect with only 0.7 mg of hydrocortisone ?

    • Gabriela Segura, MD  March 29, 2015

      Start with the lowest dose of melatonin: 0.25 mg. Guy, I think you need to see your problem from all points of view so you can answer that question. It might not be the hydrocortisone. Do read that book, it is a life saver.

  21. Mennnn  April 6, 2015

    Hello, can someone give me à protocol for progesterone for adrenal fatigue i used 15 Mg last 2 days but couldnt sleep and my back hurts (what i always experience from adrenal crashes) so can the author of this article maybe tell me how to dose it.

    I couldnt get hydrocortisone sorry for my bad english im dutch.

    Thanks in advance

    • Gabriela Segura, MD  April 6, 2015

      You have tablets or cream? After ovulation on day 14 (that is, if we ovulate) we are supposed to produce around 20 to 30 mg of progesterone per day. The progesterone cream is usually a 2% natural progesterone, so 1/4 gives around 20mg per day. A normal low progesterone dose is of 20-60mg/day (100mg per day maximum).

      • Mennnnn  April 6, 2015

        Its natural progesterone Cream 1 full push is 20 mg it says but im already crashing on 10-15 Mg it seems :’s thanks for ur answer

  22. sara  April 10, 2015

    Hi there Gabriela

    I have been diagnosed with hypothyroid (TSH 6) T4 11 T3 4.5 and TPO antibodies over 1000. I asked for other blood results including Cortisol and established this was dropping from 380 (450-90) to 200 over two months. In deeper research I am not surprised about the failing adrenals and subsequent Auto immune attack on my thyroid – both of which have clearly progressed for some time. A very stressful 10-15 years with a lifestyle that ticks all the boxes…. mother, single, child with obstructive sleep apnoea for 4 years from birth.. house moves, job losses, home losses, business losses, sleep losses, stress after stress!!!!! I won’t continue….

    Anyway – how to work my way out!? I started to remove gluten and oats and wheat from diet along with coffee and alcohol, bar the v rare slip up…. and tried to eat more healthily with coconut oils, vegetables, protein and natural juices and smoothies…. the antibodies were still high even after 2 months over 1000 with thyroid condition the same. I recognise the adrenals and stress response are at the root… I have also supplemented with selenium, iron, vitamin D3, magnesium, zinc, L Glutamine, Vit C, B Complex, A and L Glutathione whilst also taking adaptogen tinctures in Licourice and Borage for Adrenal repair.

    I am wondering if the tinctures are enough? My homeopath has also suggested I take 2x kelp tablets for thyroid function but I have heard conflicting things about this and also Fucus tincture which I added to the others.

    My GP has asked an endo to do a synacthen test on Friday and I’m nervous that the test will do more harm on what I already know are knackered adrenals…. your article is great and has given me another thread to explore. I realise it could take years of gentle healing to help the adrenals out and my gut tells me that I need to restore adrenal health and keep gut (leaky) and allergies at bay. I did a hair mineral test showing slightly low in zinc and also an Igg test which showed moderate reaction for Yeast, Wheat, Gluten and Gliadin with Candida Albanicans also showing moderately…

    Its a fascinating area and one that if I can manage to heal from I would love to raise awareness on. I am a 46 year old woman who has had to give up work to sort this out… so adding financial stress with no savings…. one Dr advised Bovine Adrenals and Betaine HCL For low stomach acid for a few weeks then Nutri Thyroid (Bovine also)…. or do I go through NHS and take what they suggest or will that shut down the glands? I’m keen to keep things as natural as possible. The vitamins and minerals and definitely helped with some of the symptoms but libido is still gone, fatigue and depression anxiety still roll in and out but I have made an improvement on iron and my dry eyes skin and hair are getting better…. it feels like some restoration is possible but I am nervous about taking one step forward and 3 backwards. Would be very grateful for your views…

    Many thanks!


    • Gabriela Segura, MD  April 10, 2015

      Dear Sara,

      Thank you for sharing your efforts to heal. I think they’re very good and that you’re heading on the right direction!

      When you have an autoimmune reaction attacking your thyroid, you have to be very careful with gluten, soy, etc. Here, I mean even the tiniest amounts and/or hidden sources. The tiniest amount, even a molecule, can trigger an autoimmune reaction in those who are very sensible. It can take 6 months or longer to calm down this reaction.

      Be consistent with your lifestyle changes and don’t get discouraged if the tests are not giving the results you want. It can really take awhile to calm your system down. In any event, the way you feel is a better parameter than any lab work. There is a huge influence of lab tests in modern medicine and they’re all not that reliable.

      I would recommend you do this stress relieving technique available online at http://eiriu-eolas.org/online-version/

      It is very important to relieve stress in practical ways. I highly recommend Eiriu Eolas because I’ve seen the changes it brings in people’s lives regardless of their lifestyles. You can pipe breathe gently in any situation and it will help you deal with stress and engage your higher cognitive abilities.

      From the way you describe your diet, I think you’re missing better and higher qualities of fat. Have regularly a good bone broth. You can add ghee butter (if you’re sensitive to regular butter) to tea, the broth, the vegetables, etc. It is the only type of “dairy” I would recommend. Although if you suspect you can’t tolerate even ghee butter, then don’t risk it.

      Don’t be afraid of animal fat: fatty cuts of anything will do you a great deal of good. You can read a good summary on how to approach the diet in this article.


      Do stay away from cruciferous vegetables for the time being though.

      I don’t have enough experience with homeopathy to discourage it. I heard good testimonials, but the key being a good formula which can be difficult to get by.

      If you don’t have anemia, I would absolutely remove the iron as it causes oxidative damage. Iron supplements are the worst idea and should be reserved for iron deficiency anemia. Iron overload is a huge problem in today’s modern diseases. If your Hemoglobin is lowish, but you don’t have anemia, then let go the iron supplementation.

      Low stomach acidity must be addressed. You can have apple cider vinegar with your meat in order to help you digest. Supplementation with betaine HCl might be required though.

      If you can get a good probiotic with lactobacillus rhamnosus gg on it, that will help you with your leaky gut, yeast overgrowth and stabilizing your immune system as well. Finally, make sure to have little fish like sardines and omega 3s. If you’re getting bovine adrenals, make sure you get adrenal CORTEX and not the medulla. The later one can aggravate your symptoms.

      Make sure you sleep in total darkness. Even a light patch behind your knee can disrupt melatonin production even if you don’t see it. Avoid electronics before bedtime and sleep well. Healing occurs while you sleep and having a bad night can set back all your dietary and lifestyle efforts. The breathing exercises in total darkness are a good way to have a good night sleep.

      I think you have done a great work collecting all this information and that your efforts will pay off. Nothing like taking good care of yourself!

      All the best!

  23. sara  April 10, 2015

    Forgot to mention, have also excluded soy and diary (bar the odd bit of chocolate!) & raw cruciferous veggies from diet…. have read around the subjects ALOT and seem to be assisting GP on matters, but the adrenals seem to elude everyone!

  24. Amy M  April 13, 2015

    I have low aldosterone levels (4) and low cortisol levels. I have got the Hydrocortisone and am considering taking it as you have suggested to see if it helps me feel better. I’m on florinef but it doesn’t seem to help at all. Also adrenal cortex makes me feel more wired and tired as do all the adrenal supplements my integrative dr has given me.

    My Question to you is:

    When will we know to stop taking the cortef?

    Should we take adrenal supplements during that time?

    Can I take Low dose cortef while doing a candida cleanse?

    thanks so much!

    • Gabriela Segura, MD  April 13, 2015

      Hello Amy,

      Stop all the other adrenal supplements while on cortef. You can take it while doing your candida cleanse, in fact, low dose cortisone can be taken when you are sick (or about to fall asleep), over stressed and so forth. It strengthens your reserve to withstand disease and stress. You can stop it any time you want and/or if uncomfortable with it. You can start taking it and stop it after feeling better. I would do it at least for 3 weeks. Start with the lowest dose possible first thing in the morning and work from there. Best!

  25. Lynn  April 22, 2015

    Hi. I have had high cortisol levels in AM for years and all symptoms of adrenal fatigue for years. I pretty much burned myself out by working too many hours, no exercise, poor eating, lack of sleep and much stress on my job. I am no longer at that job. My doctor has been treating me for over a year for hormone imbalance, depression and fatigue. She balanced my female hormones with bio identical hormones; I am on Armour Thyroid 30mg for hypothyroid. I have had high AM cortisol for over a year. She treated me with high dose B comIex vitamins. It didn’t lower. I was sluggish in AM upon rising. I would crash in afternoons and then be wired in late pm. So, she put me on 10 mg of hydrocortisone for 6 weeks and then off for 6. I felt better, but AM cortisol still too high. Actually, my AM levels increased from 22 to 31 after the 6 weeks on 6 weeks off. She had me start again on 5 mg of hydrocortisone. I have taken it for 2-3 weeks. I feel better. Sleep better. I stopped taking it this AM because I have been closely monitoring my weight, eating primal, getting proper sleep, lots of water and I am not loosing weight. I went up 4lbs within days of restarting hydrocortisone, with no dietary changes and the 4lbs has remained, despite exercise, primal/keto diet and watching calories. I am supposed to take the 5 mg for 2 more months, though she said I could stop if I felt like I was better. I feel better, so I am stopping today. I read your article about dosing and you mention you can stop after a few days if you feel better. Am I risking by stopping now? Or, is it counterproductive to keep taking the 5mg daily if I am feeling better. I am frustrated because I am really making a committed effort to lower my weight. I am overweight. I exercise 5-6 days a week cardio, HIT and weight training. I don’t exercise exseviely. Besides eating low carb, low processed foods, no soda, low sugar, primal, and no alchohoI am not budging on scale. I rarely have gluten. I also started following Dr Mercola’s recommendation for intermittent fasting by restricting eating to an 8 hr window a month ago. The hyrdrocortisone dose is low and shouldn’t be interfering, but could it be? Also, I was taking 150mg of 5-htp at bedtime. until a few days ago. She had me take that because of low serotonin an depression. I read that 5-htp can increase cortisol, so I stopped taking it 5 days ago. My mood has not gotten worse, my sleep is good. I had been on it for a year, but I thought it was counterproductive to take it if it increases cortisol. If I quit the hydrocortisone, would it be advisable to restart 5-htp? At this point, I think stopping hydrocortisone is best. But am I wrong? I understand when cortisol is too high, your body stores fat especially in abdomen, and that is where I am struggling. I have read primal body/primal mind book. Thank you for your time. Not many doctors are familiar with adrenal fatigue. My doctor is somewhat.

    • Gabriela Segura, MD  April 23, 2015

      Hello Lynn,

      I think your intuition is right. If you are feeling better, you don’t need the cortisol in AM. In your case, I would do some systematic detox with FIR sauna to help dislodge toxic residues from your fat, it will facilitate weight loss and overall health. It will add up to your detoxing efforts. For more info, you can read this quote from the book “Detoxify or Die” by Sherry Rogers:


      Hope this helps.

      • Lynn  April 23, 2015

        Thank you for taking the time to read my post and reply. I have a FIR sauna, and I will use it more. I usually try to hit it 3-4 times a week. Thanks again!

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