Do you feel like you constantly have to push yourself to get through the day? Are you tired all of the time and find that you need coffee or caffeine all day long just to keep you going? Fatigue is a very common complaint and it is something that is very treatable once the root cause is discovered. While many people may brush off their sluggishness as normal due to a busy lifestyle, fatigue is often a symptom of something bigger going on in the body.


There are many different causes of fatigue. Our physicians will take a detailed medical history and comprehensive physical exam in order to discover and treat the culprit.

Some common causes of fatigue include:

  • Adrenal fatigue
  • Stress
  • Thyroid disorders
  • Insulin resistance and Diabetes Mellitus
  • Chronic viral and bacterial infections
  • Autoimmune diseases
  • Hormone imbalances
  • Food intolerances
  • Sleep disorders

Adrenal Fatigue

In today’s environment many people are succumbed to stress on a long term daily basis. Stress in short terms is normal for the body and causes elevated cortisol to help the body cope with stress. The problem occurs when a patient cannot escape their stressors, which leads to the body coping by decreasing the production of sex hormones and other bodily functions. The term Adrenal Fatigue can in many ways be misleading, because it describes a variety of different states that we reach on the path to adrenal exhaustion. In fact, most Adrenal Fatigue sufferers thankfully never reach the latter stages of the condition, and often recover fully from stage 1 or stage 2 Adrenal Fatigue without ever being properly diagnosed.

During the various stages of this condition, hormone and neurotransmitter levels can fluctuate dramatically. In order to correctly interpret the lab tests used to detect Adrenal Fatigue, we need to fully understand the way that the body’s systems interact during each of these stages. Only then can we pinpoint the stage of Adrenal Fatigue that we have reached, and begin an appropriate treatment plan. On this page is a summary of the four discrete stages of Adrenal Fatigue. As you will see, the gradual development of adrenal exhaustion is a complex process. The only way to test to see what a patient’s stress hormone is doing during an entire day is by testing saliva cortisol levels.

Stage 1: Beginning the ‘Alarm’ Phase

This stage describes the body’s immediate reaction to a stressor. This stressor can be an imminent physical threat, or something as simple as a job interview or hospital stay. This is a normal stage and is meant to be an adaptation mechanism to stress.

During this first phase of the stress reaction, the body is capable of making significant amounts of the hormones that you need to mount a response. If you get lab tests during this stage, they would show elevated levels of epinephrine (adrenaline), norepinephrine, cortisol, DHEA and insulin.

During this stage you will likely benefit from a state of increased arousal and alertness. However, sleep patterns may begin to suffer and you may feel intermittent tiredness. Individuals rarely report their symptoms during this phase, and in fact many of us go in and out of Stage One multiple times throughout our lives.

Stage 2: Continuing the ‘Alarm’ Phase

As the stress response continues, so does your body’s reaction to it. During this second stage, your endocrine system is still fairly well equipped to produce the hormones that you need, but your levels of DHEA and other sex hormones may start to drop. This is because the resources needed to produce the sex hormones and other resources are being diverted to production of stress hormones like cortisol.

During this stage you will start to feel the effects of over-exertion of your adrenals. A common feeling is that of being “wired but tired”, where you are maintaining alertness when you need it during the day, but then crashing hard in the evening. Many Adrenal Fatigue sufferers begin to develop an unhealthy dependence on coffee during this stage. Sleep patterns can be disturbed as well but not always.

Stage 3: The ‘Resistance’ Phase

During this stage, your endocrine system continues to focus on producing stress hormones at the expense of sex hormones. This means that you will start to see substantial drops in hormones like DHEA and testosterone, as hormone precursor material is diverted towards the cortisol production pathway. The key here is a hormone named pregnenolone, which is the precursor to both the sex hormones and cortisol. This diversion is named the ‘pregnenolone steal’. We can also see a rise in blood pressure and the beginnings of accumulation of truncal fat or visceral fat. This is where the health risks come into play. Aside from the weight gain but patients can see more serious degrees of sleep pattern changes, fatigue and depression.

At this point, the individual is still able to function, hold a job and continue a pretty normal life. However, he is experiencing lower levels of many important hormones and this can make a significant difference to her quality of life. Typical symptoms might include regular tiredness, a lack of enthusiasm, regular infections and a lower sex drive. This phase might continue for several months or even years.

Stage 4: The ‘Burnout’ Phase

After some time the body simply runs out of ways to manufacture stress hormones, and cortisol levels finally begin to drop. Now, the levels of both the sex hormones and the stress hormones are low. Levels of neurotransmitters are often also low. This is what is sometimes called ‘burnout’ (a term coined by Dr. Fredenberger), and it is what happens when we finally crash after a long period of coping with stress.

During this final stage of Adrenal Fatigue, an individual can suffer from extreme tiredness, lack of sex drive, irritability, depression, anxiety, weight loss, apathy and disinterest in the world around him. In fact, this general hormonal insufficiency has important implications for almost every part of the body. To recover from Stage Four Adrenal Fatigue most times requires professional help as well as significant time, patience and often a complete change in lifestyle.


Our naturopathic medical doctors will run labs to identify where you are at in the stages of adrenal fatigue. We can then help push the body back into the right direction by taking stress off of the adrenal glands through diet and lifestyle changes, balancing hormones, and supplements and herbs to help the body better cope in stressful situations. With these changes patients will often feel a new bliss towards life and discover that they no longer have fatigue and can get through the day like they did when they were younger.

Live Well Wellness Center
2905 West Warner Road, Suite 25
Chandler, AZ 85224
Phone: 480-752-7600
Fax: 480-456-8919
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