Written by James L. Wilson, DC, ND, PhD

Many of my patients who suffered from the effects of adrenal fatigue and chronic stress often asked: “How did I end up this way?” The descriptions given below are snapshots of the most common patterns of adrenal fatigue I have seen clinically over the past twenty-four years. It is important to realize that these are not one size fits all and each person suffering from adrenal fatigue has his or her own variation.

Pattern #1 – Prolonged resistance phase followed by adrenal fatigue

The first pattern is what is popularly referred to as the “ironman / ironwoman.” These are people who seem to be bothered by nothing. They maintain a resistance stage most of their lives, being able to handle anything thrown at them. Although stress may get them down for a day or two, they predictably bounce back as good as new. Usually these people remain in a resistance stage until late in life when old age diminishes their adrenal function. Clinically, these people would appear to have lost some of their previous ability to handle stress following a major life event (accident, illness, highly emotional situation, etc.).

An example of this pattern is the person who can handle anything at work. They take on larger work loads and does whatever is demanded with no problem. Then one day an extremely stressful event occurs, such as a major illness, surgery, or a marital break-up, and after that they seem much less able to handle the stresses of their job. Even after a time of recovery they may not be able to be that same go-getter. If salivary cortisol levels were checked carefully, they would probably be mildly elevated at first, but after the event they would be mildly suppressed. If they took my questionnaire it would likely show many of the indications of hypoadrenia or adrenal fatigue.

Chances are the ironman or ironwoman did not view the added workload and responsibilities as stress, but rather something gladly taken on. However, the added responsibilities and work were their undoing. This is a very common pattern, and these people usually have an excellent chance of recovery if they can avoid the temptation to live on a constant “adrenal high” (that rush of continually pushing themselves to the brink to take on the world). If they continually push themselves, they can develop a pattern like the last part of this pattern or like #3.

Pattern #2 – A single stressor followed by adrenal fatigue

There is a type of adrenal fatigue that can occur in people after only one stressful event. This pattern is similar to the first except there is no long phase of resistance. There is the typical alarm reaction and recovery phase, but only partial recovery is seen. These people never totally rebound from the recovery phase. Instead of progressing to the resistance phase, their cortisol levels remain below average, but at a level just high enough to allow them to get through daily life, but with many of the symptoms of adrenal fatigue.

Because the adrenal glands in these people do not have the resiliency to rebound after a severe stress, they have to function at a lower level with decreased adrenal output (as evidenced by the low cortisol levels). These people can recover with diet and lifestyle changes, dedicated adrenal support, as well as making strong efforts to reduce and manage their daily stress load.

Pattern #3 – Repeated partial recovery followed by recurring
adrenal fatigue

This pattern occurs when people experience a series of stressful events over time that keeps their adrenal glands working at redline levels until the point their adrenals become fatigued and the stress response weakens. After an initial shock or alarm reaction these types go through repeated cycles of resistance and exhaustion, but each time they are able to return to a stage of resistance and function with above normal levels of cortisol. These people can carry on in a stage of resistance for several years until another major stressor or a series of stressors overwhelms them, after which is usually a longer recovery phase that once again elevates them to the stage of resistance. The larger the stress, the longer the recovery.

The people who follow this pattern usually have relatively strong adrenals but are unable or unwilling to change their continual encounters with stressful situations. Over time life beats them down, leaving them much less able to endure stresses that they previously would have handled with ease. These can be very willful individuals who refuse to change or they can also simply be people who unavoidably experience an unfortunate series of circumstances in life. Guidelines for recovery in this phase are the same as the last.

Pattern #4 – Gradual decline into adrenal fatigue

This is a pattern of gradually decreasing resistance to stress. The people who exhibit this pattern experience many stresses over time but with each event their level of recovery diminishes. They are less and less able to return to high or even normal cortisol levels until, finally, their adrenals become so fatigued that they cannot handle anything more stressful than an uneventful routine day. Cortisol levels may start out higher than normal but gradually drop below normal and then remain low, unless a concerted effort is made to help their adrenals recover. With time and dedication to a recovery program, those in this pattern can also bounce back.

This is a frequent pattern seen in strong willed perfectionist people who constantly subjugate their own needs to “do their duty.” It may be work, family or social demands that drive them, but the result is often the same. This is also a frequent pattern seen in single parents or in people who refuse to ask for help, trying to do it all themselves. Changing their physiology to recovery from adrenal fatigue is usually not the challenge. The challenge comes with changing the attitudes and beliefs that have driven them to adrenal fatigue.

The original blog can be found here.

Dr James Wilson

James L. Wilson, DC, ND, PhD, received his Ph.D. in Human Nutrition from the University of Arizona, with minors in Immunology, Microbiology, Pharmacology and Toxicology, and research in Cellular Immunology. His doctorates in Chiropractic Medicine and Naturopathic Medicine are from the Canadian Memorial Chiropractic College and the Ontario College of Naturopathic Medicine (CCNM).

As one of the 14 founding members of CCNM, now the largest Naturopathic College in the world, Dr. Wilson has long been on the forefront of alternative medicine. For over twenty-five years, he was in private practice in Canada and the United States. In 1998, Dr. Wilson coined the term ‘adrenal fatigue’ to identify below optimal adrenal function resulting from stress and distinguish it from Addison’s disease.

With a researcher’s grasp of science and a clinician’s understanding of its human impact, Dr. Wilson has helped many physicians understand the physiology behind and treatment of various health conditions. He is acknowledged as an expert on alternative medicine, especially in the area of stress and adrenal function. Dr. Wilson is a respected and sought after lecturer and consultant in the medical and alternative healthcare communities in the United States and abroad.

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