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so i got my tests back, and one of the issues is low cortisol - which is interesting because i thought low cortisol was good. turns out, optimal cortisol is best, low or high is bad. so apparently i used up my cortisol years ago fighting stresses and its now to the point where i have fatigue and pain. it also ties in with low testosterone, and higher than necessary estrogen ratios.

anyone familiar with reversing this trend?

some more info: i'm 31 ,male, 6 foot 185 lbs. spectracell labs were near perfect with nutrients except b5 and cysteine - will take supps b5 and NAC soon. dairy intake is more only recently (post labwork) i.e. kerrygold butter. been taking FCLO & HiVit Butter Oil since december about 2 tsp each daily. i do not eat many starches as i tend to gorge and/or bloat on them. instead i eat a bit of brown rice syrup daily as per jaminet's recommendation. i eat tons of red meat, organ meat, and eggs all high quality with sauerkraut and liberal sea salt. started upping vit c, even though i drink many fresh squeezed lemons daily for years. i take natural calm nightly and sometimes apply magnesium oil on my skin.

Edit: none of this worked. I now follow ray peat to focus on thyroid and decreasing stress marker.

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 The same thing happened to me. Lots of vitamin C, pantothenic acid and salt in my drinking water helped immensely. I also used Licorice Root and Ashwaganda at first, too. – Helen Feb 8 2011 at 22:14
Helen, Could you please be more specific regarding amounts, and how long you used the above? I've been looking into this topic more, so any info is useful. Thanks :) – Todd Feb 8 2011 at 22:18
I'm really sorry, Todd, but I don't feel right commenting about amounts because what was good for me might not be right for you. I really apologize, and I wish you much luck healing your adrenals. – Helen Feb 8 2011 at 23:21
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 helen, if you preface your answer with your details, such as weight and height, etc - you wont be violating any ethics and will help others, thanks. – dsohei Feb 10 2011 at 20:15
Heya, how are you measuring cortisol? Salivary, serum, urine sample, 24-hour urine? – Not James Mar 25 2012 at 5:31
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9 Answers

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Though I haven't read the whole thing, the book Feeling Fat, Fuzzy, or Frazzled?: A 3-Step Program to: Restore Thyroid, Adrenal, and Reproductive Balance, Beat Hormone Havoc, and Feel Better Fast! seems to have well researched advice.

In sum it divides intervention into stages:

First,

  • Eat frequently, take salt, and avoid caffeine, alcohol, tobacco, and sugar
  • B5 250 mg, 2-3/day
  • B6 50 mg, 2-3/day
  • full strength licorice, 300 mg/day first week, increase by 300 mg/day for several weeks (watch blood pressure)

Then add tonics/adaptogenics:

  • ashwagandha root powder 600 mg/day
  • panax ginseng 400 mg/day
  • cordyceps 800 mg/day
  • rhodiola root 100 mg/day
  • bacopa 500 mg/day

Next, add precursor augmentation:

  • DHEA 5-10 mg/day - gently titrate up with supervision no higher than 25-50 mg/day
  • pregnenelone 50-100 mg/day

Finally, glandulars.

Again, I haven't read all of this, and there may be important specifics I've not written here. Nor have I read the justification or evidence for each part. Also, having the help of a practitioner is strongly recommended by the author.

My interest in this came from exploring the reasons for my low and variable body temperature. Back in December I tried the pupil dilation test and had a lot of vacillation. I started taking magnesium and vitamin C, adding sea salt to my food, and drinking strong licorice tea daily, and last week my dilation was almost perfectly normal. I haven't tested my temperature steadiness recently, though.

(See Those durn adrenals: How they can wreck havoc in many thyroid patients and scroll down, for self-tests for adrenal fatigue, though if you already have confirmed low cortisol, that should be definitive.)

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I am not so sure DHEA supplementation or pregnenelone is optimal. Why down regulate your bodies own production of those hormones? From his history it sounds like he messed with drugs or maybe I am reading into too much of it? Which could have alot to do with his hormone levels. His pituatary is still functioning if his estrogen is high... if we were talking complete hypopituitarism wouldn't all hormones be low? – Bill Feb 12 2011 at 19:12
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 Yes, once you get into taking hormones or precursors, it's risky and controversial. I'm just reporting what this author suggests. Of course it's best if you can see progress with just the first 2 stages of intervention, and then you don't have to weigh those pros and cons. – Ambimorph Feb 12 2011 at 23:49
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dsohei,

Ck out Robb's post (yeah I'm the 'grace')

http://robbwolf.com/2011/01/24/my-training-at-39/

Adrenal insufficiency can probably be typed into 3 flavors: --pituitary dysfunction (HPA axis failure) --adrenal dysfunction --mild dysfunction -- 'fatigue'

It is ALL ENTIRELY reversible.

Adress the mental stress and physical trauma (e.g. even stop HIIT, cardio, xfit, intermittent fasting, ketotic diets -- these are all depleting for adrenal function). If you are on a synthetic hormone (birth control) or a drug that kills cholesterol (statins or other cholesterol lowering therapy) STOP IT RIGHT NOW.

Address the gut --heal it

Take the nutrients that are depleted: zinc, vitamin C (as mentioned above), fat soluble nutrients (grassfed animal fats, chol rich egg yolks (if not allergic), ghee/butter, vitamin D3 supplementation if deficient, omega-3 fish oil, phosphatidylserine (AWESOME STUFF for adrenals), amino acids, melatonin, etc

-G

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hi grace, can you elaborate on the phosphatidylserine? – Tom Feb 9 2011 at 8:05
I think the phosphatidylserine is actually used for high cortisol, not low. – Ambimorph Feb 9 2011 at 14:40
Can you explain why a ketotic state is supposed to be harmful in this case? Is it based on experiment, a plausible mechanism, or just speculation? – Ambimorph Feb 9 2011 at 14:41
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You should look at the following resources: ADRENALS FAQ–the most frequently asked questions, and Dr. James Wilson's Adrenal Fatigue

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That's true, and he's selling them. Nonetheless, I think the kinds of supplements he recommends may truly be helpful. I've looked a little bit at the book "Fat, Fuzzy, and Frazzled", which is about three major types of hormonal imbalances, including adrenal fatigue. The protocol suggested there for adrenal fatigue is similar to Wilson's, but different in a couple important ways. I'll make a new answer of it. – Ambimorph Feb 12 2011 at 15:16
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After I was diagnosed with low cortisol, via a diurnal saliva test, I tried vitamin, mineral, glandular, and herbal supplements, but to little effect. Ultimately what helped me was hydrocortisone pills, which require a prescription. I started with 5mg/day and worked up to 25 mg/day in split doses. At some point after my adrenals have had a chance to recover I'll start tapering off the hydrocortisone and let my adrenals slowly make up the difference.

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This is the answer I wrote in another very similar thread:

I'm also in the cortisol/adrenal fatigue situation. I've been looking into this for a while now.

Although diet definitely helps, this problem has to be resolved at it's core (vs dealing with it's symptoms). That is, the most obvious things to do are to decrease cortisol and reverse adrenal fatigue. Most of these come from lifestyle changes (getting enough sleep, decreasing work and exercise stress, increasing exposure to sunlight, etc.)

The same rule applies to all other aspects of a lifestyle: decrease any practice that is a potential stressor.

With regards to dietary considerations. In order to decrease the stress on your system, I would recommend increasing your carb intake to around 100g a day (as being in a state of ketosis adds extra stress to the system). Carbs should come mostly from starches and you should always avoid fructose. I am assuming you are at least 95% paleo, if not, getting there will help a lot.

Don't fast or IF or skip breakfast, although these practices are generally beneficial, they are only so when one's body is healthy. Again, they add unnecessary stress.

As for workouts, they should also be less "stressful" i.e. avoid metcons and endurance exercices, go for heavy lifts instead (press, lifts, cleans etc.) , not too much though. Don't workout on an empty stomach.

Other, less important stuff: drink green tea, contains L-theanine which helps with managing stress. Supplement with magnesium, adrenal fatigue decreases your body's retention.

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This is a normal symptom of adrenal fatigue, you're adrenal glands can't keep up and don't produce the required amount of cortisol. "Adrenal Fatigue: The 21st Century Stress Syndrome" could be an interesting book to read. – Dave Mar 1 2011 at 15:24
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Make sure your eating some starch... keep carbs around 100g per day. Don't IF. Keep any HIIT or intense cardio to once a week, 20 mins max. Lift heavy twice a week for testosterone. Lots of egg yolks, red meat. Have you just lost a bunch of weight? Make sure you are sleep 8 hours a night.

Meditate, practice yoga. Make sure your laughing, smiling, having fun more. Relax.

I would suggest against melatonin as mentioned by grace... it is a hormone and continued use will only further disrupt your own hormone cycles.

Sex if you can.

Focus on just getting that Test up by lifting heavy twice weekly... like REALLy heavy doing deadlifts, squats, bench, overhead press.. only twice. Keep sessions around 30mins. Walk. Tons of cholestorol. Organ meats, egg yolks. TONS of red meat.

For the high estrogen... are you using alot of plastics? Eating alot of dairy? What about beauty products? These can all contain estrogenic substances.

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Not to sound like a broken record, but what is the evidence that this starch intake (which I infer is supposed to take you out of ketosis) helps with adrenal fatigue? – Ambimorph Feb 9 2011 at 14:43
ALot of people who go VLC for a long period of time complain of these type of symptoms... they vanish when the carbs are upped. – Bill Feb 9 2011 at 18:24
That would be pretty good evidence. Can you point me to some? – Ambimorph Feb 9 2011 at 19:03
Are you on some kind of medication? Have you taken any medication? Have you had some kind of chronic infection? – Bill Feb 10 2011 at 2:44
Also.... are you eating enough? Have you recently lost a bunch of weight? – Bill Feb 10 2011 at 2:48
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How was your cortisol measured (serum , saliva, 24 hour urine), and at what time of day were you tested?

To diagnose low cortisol output you need a 24 hour urine test.

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Based on a single 11 am serum reading you can not tell much of anything. Many people fall into a pattern where they overproduce cortisol in the morning, then do not produce enough in the afternoon. Others underproduce cortisol all the time. To see if you have adrenal exhaustion you need a 24 hour urine test. To se if you are over then underproducing you need something like the ZRT Labs saliva cortisol profile, preferably suplemnted with 8 am and 4 PM serum cortisol tests. Once you determine what your situation is then you can potentially take the best approach to treat it. – TheOriginalKaz Feb 18 2011 at 1:11
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What helped for you? I am in the same place, but I have PTSD, which accounts for why. High estrogen, low cortisol, fatigue, chronic daily headache, period issues. I want natural, since I already take meds for the PTSD.

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Look into ray peat, paleo is only a first step and doesn't work for what u and I are dealing with. There are radical therapies that basically cure ptsd issues - I used them. Contact me privately if u want. – dsohei Mar 25 2012 at 4:52
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I know I'm late to the show. But I'm a 20 year old with low testosterone, hypothyroidism, and adrenal fatigue. Could years of hypothyroidism and adrenal fatigue cause low testosterone? Haven't seem a connection on that.

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yes. but, welcome to the rabbit hole. i hope you find what you need quickly and without bankrupting yourself. they are all connected. something happened to you during the womb, birth, and childhood that caused some kind of hpa axis dysregulation and that sens the body into death countdown. my advice is to learn to meditate and de-stress/increase non-stimulatory pleasure, and find a good chinee herbalist who understands the old shamnic way of healing. – dsohei Mar 16 at 22:45

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