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How is Adrenal Fatigue Diagnosed and Treated?

by | Last updated: Jan 11, 2023 | Adrenal Issues, Blog | 2 comments

Conventional medicine does not recognize adrenal fatigue. Why? Because while adrenal fatigue is not optimal functioning, it is not a disease. Allopathic practitioners treat diseases. Complete adrenal failure is called Addison’s disease – or primary adrenal insufficiency. It is most often caused by an autoimmune condition in which the adrenal cortex is destroyed. So your adrenal glands no longer produce cortisol. You need cortisol to survive, so you are given synthetic cortisone for the rest of your life.

Why wait until you have full-blown Addison’s disease? Why not stop before you fall off the cliff?

To properly diagnose Addison’s disease- blood tests are done. If cortisol levels are decreased and adrenocorticotropic hormone levels increased then a cosyntropin stimulation test can confirm the diagnosis. 

Adrenal fatigue can be a little hard to diagnose. We don’t have any classic measurements.  There is a decline in adrenal hormone production that affects your ability to function. 

Adrenal fatigue is when you’re producing low levels of cortisol.

Either all day, or you don’t have enough precursor to produce enough cortisol when you exercise or react to a stressor or enough cortisol to release stored sugar after you eat.

So we diagnose adrenal fatigue by your history – looking for signs and symptoms. 

Are you fatigued, especially in the afternoon, do you have fatigue, all day long? 

Do you get dizzy when you stand up because your blood pressure is low meaning you’re not producing enough aldosterone? 

Are you gaining weight around your middle? You may have lost weight in the beginning of your adrenal stress but then you start gaining weight typically as around your belly. 

Do you have metabolic markers in your blood – high levels of CRP – cardio reactive protein – indicating inflammation?

Blood tests can be done to measure your cortisol and ACTH levels. ACTH is the acronym for adrenocorticotropin hormone. ACTH is necessary to tell the adrenal glands to produce cortisol and other hormones. Cortisol levels follow a natural cycle throughout the day; they are highest in the morning, so most likely your health care provider will want to draw these labs around 8 am.

But if you get very stressed by getting a blood test done, you may have a little surge of cortisol which will make it look normal when it really isn’t normal for you.

So what helps me diagnose adrenal fatigue is to look at DHEA levels in my patients.  

When your body produces adrenaline in response to a stressor, you then start producing cortisol to fuel the fight or flight response. After cortisol is produced you produce DHEA an anabolic hormone that helps you to metabolize protein and fat, literally to heal up any of the damage from the fight or flight response. So, measuring DHEA both unconjugated forms to look at your reserve, and the conjugated form DHEA -S can give us an idea of your cortisol reserve. 

Cortisol can be measured in your saliva too. Adrenal function tests require multiple saliva samples throughout the day. Again, you may not be able to see super low cortisol function. If the day that you measure cortisol is particularly stressful you can have some spikes in cortisol even if you’re adrenals are fatigued. Remember adrenal fatigue is not complete adrenal failure like Addison disease. You still have some adrenal function. 

So diagnosing Adrenal Fatigue takes a little bit of finesse.

I always look at some other hormones that give me information about the hypothalamic-pituitary-adrenal response. But we’re going mainly by signs and symptoms. 

Adrenal fatigue is recognized by integrative medicine as a treatable condition.

Integrative medicine recognizes less than optimal functioning as something that can be improved through better lifestyle choices, detoxification, and supplementation.

Adaptogenic herbs, B vitamins, essential fatty acids can help adrenal glands recover. Glandular products are also useful initially to support adrenal function. Sometimes bio identical cortisol and DHEA is prescribed to supplement adrenal function.

I believe the body will heal itself given the proper nutrients.

So first I recommend a foundational support to heal the adrenals as well as all the organ systems affected by stress. Getting the adrenals functioning properly will stop the hair loss, weight gain, and aging, but the body needs extra nutrients to grow hair and healthy skin, improve body composition to increase lean body mass and decrease body fat, and optimize health.

Then I recommend hypothalamic support to improve the communication system between the adrenals and the brain. Supporting the hypothalamus allows it to orchestrate the rest of the endocrine system as well as the neurological and immune system to harmonize the symphony of hormones, neurotransmitters and cytokines so your DNA dances optimal health and well being.

Yes, I recommend adrenal glandulars and adaptogenic herbs to boost adrenal activity. But revving the engine without providing gas and oil will burn out the vehicle.

Genesis Gold® is the fuel the body needs to detoxify, rebuild and heal itself. Sacred Seven® amino acids provide the hypothalamic support to optimize genetic function.

For my patients who need extra support during times of stress, I developed a natural treatment protocol for adrenal fatigue. It includes extra adrenal glandular support, adaptogenic herbs, essential nutrients plus homeopathic adrenal cortex with full instructions on how to use supplements. My DMAR Natural Adrenal Therapy is a great rescue measure until your hypothalamus can get back in balance with Genesis Gold® and Sacred Seven®. 

If you have any questions about how to diagnose and treat adrenal fatigue, you can join us in our Hormone Support Group. You can get access through our free Hormone Reboot Training. It is all about helping you understand how your hypothalamus works to affect your hormones and so much more.

About the Author - Deborah Maragopoulos FNP

Known as the Hormone Queen®️, I’ve made it my mission to help everyone – no matter their age – balance their hormones, and live the energy and joy their DNA and true destiny desires. See more about me my story here…



  1. Sherlynn Emler

    I’m 44 yo F. Hx: adrenal fatigue with history of severe chemical sensitivities, fibromyalgia, a adrenal PCOS w/ elevated adrenal androgens – intermittently elevated DHEA (highest – 718) and progressive increase in DHEAS (171); DHT also increased (max 22) with s/s hyperandrogenism (androgenic alopecia, facial hair, oily skin) <7 months p laparoscopy with L oophorectomy, dense pelvic adhesions removed. Menopausal sx (rUTIs, r vaginal infections, urge incontinence). Sweats and flashes but not sure from menopause or adrenal stress. Can you discern between adrenal vs ovarian source of sweats/flashes? Genesis Gold sounds like a good option to regulate hormones however, I don’t want to exacerbate adrenal androgens and related hyperandrogencity. Will GG reverse this?

    • Deborah Maragopoulos FNP

      Yes Genesis Gold can help by optimizing your hypothalamus function

      The root of PCOS lies in hypothalamus dysfunction as does adrenal stress

      My patients and customers with PCOS notice decrease in hyperandrogenism by calming overactive ovarian theca cell production of testosterone and reducing insulin resistance as well as regulating the HPA axis to reduce overproduction of adrenal androgens

      Your menopause symptoms are classic signs of hypothalamus dysfunction

      It takes time at least 90 days to begin healing hypothalamus dysfunction

      You can hasten hypothalamus healing by adding extra Sacred Seven hypothalamus amino acids to Genesis Gold for a few months


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