I've been planning this post for a long while. I wanted to give the therapy a decent time before reporting, because I'm one of those people who often thinks supplements are helping at first, then after a while they stop working. I've given it 7 months so I am really sure this is working for me. My cortisol levels were measured about 18 months ago and were 4 and later 7. This is even lower than many people with Addisons disease. I briefly took a low dose of steroid which made me drastically worse. I read "Adrenal Fatigue" by James Wilson and here's what the book says. (BTW none of this is cutting edge or controversial, there are articles about all of it on Wikipedia and other websites) The adrenal glands produce the following hormones: 1. adrenaline and noradrenaline for "fight or flight" reactions 2. DHEA, pregnenolone, progesterone, estrogens, testosterone, androstenedione - antioxidant, tissue repair, sex hormones, cortisol balancing and anti-aging functions 3. cortisol - blood sugar regulation, anti-inflammatory, immune response modification, heart and blood vessel toning, central nervous system stimulation, stress reaction normalisation 4. aldosterone - regulation of potassium, sodium and fluid volume When you have low levels of these hormones, the symptoms are: 1. dopey reactions 2. Men need low level female hormone and women need male ones, these are made exclusively by the adrenal glands. Women with low testosterone have no sex drive, for example. (That's why women never want sex when they're tired!) They also produce top ups of hormones for our own gender that fine tune. When low, for women you feel terrible the week before your period, for example. These hormones do many others things in the body that are not yet fully understood. 3. low blood sugar, especially rebound reaction (peak then crash) after you eat carbs - often sugar cravings; chronic inflammation, leading to frequent headaches pains and other signs of inflammation - in long term can lead to autoimmune reactions; overactive lymphocytes - recovery from infections takes too long because immune system doesn't know when to stop; cortisol keeps mid-sized arteries suitably contracted, when it is deficient these are too dilated and you have chronic low blood pressure - also uses many minerals to ensure the heart muscle beats forcefully enough but not too hard; lack of cortisol in central nervous system causes general dopiness and sleep disorders (too high cortisol causes sleep disorders too); Stress as a medical term means injury, infection or psychological trauma which provokes a cascade of other hormones - cortisol regulates and coordinates all the necessary reactions to these situations to ensure the body heals and gets back to normal as fast as possible - lack of cortisol means you take far longer to heal from injury or infections 4. Lack of aldosterone causes OI, POTS and chronic low BP. The treatment that the book recommends is the following nutrients: Vitamin E 800 IU daily (try to get mixed tocopherols not just alpha tocopherols if at all possible) Pantothenic acid (vit B5) 1,500mg daily (I use Jarrow which is great) Vitamin B6 50 to 100mg daily. (I was already on 50, increased to 100 and half of this is the active form called P5P, this is beacause I think I am one of those people poor at converting it to the active form, the usual test for this is whether you have dreams or not, if not, you are not getting enough) buffered vitamin C, as much as your intestine can take, at least 6000mg daily (increase by 100mg daily til you get doarrhoea, than go back to the dose that was OK. I'm on 9,000mg daily.) Niacin (Vit B3) 25 to 50mg daily Magnesium 400mg daily Calcium 1000mg daily Fibre (psyllium husk or whatever - this is because you will be dumping more toxins through your bile duct and you need to trap the toxins so they are not reabsorbed. I didn't take enough to begin with and this really matters. I need 3 teaspoons a day (half an hour before each meal) There are also things you must avoid: No caffeine at all Any time you want a sugary snack, have a salty one instead- this will actually give you more energy as it helps your available cortisol do its job rather than giving it extra work to do regulating your blood sugar. No fats that have been damaged by heat, i.e. no saturated fats. You also have to take a fairly ruthless approach to avoiding stessful situations, seeking out things that make you laugh, taking lie-downs and rests as often as you can and make sure you are asleep by 9.30 or 10 pm before that second wind that usually comes on about 11 pm kicks in. Spending a very long time chewing your food helps the last stage of methylation - actually secreting toxins in bile into your intestine ready for elimination, and it relaxes you too and helps you digest your food better, thus getting more nutrients out of it. I took about 2 or 3 days in "startup mode" but I was fine after that. Startup mode meant I felt hyperactive and could not relax properly - it was like a feeling of constant agitation. Tired but wired. Actually a bit better than my usual sensation of feeling stoned, but not really what I wanted. When I overdid things I would get that tired but wirded feeling back again in the first 2 months, but it has stopped now. When your adrenals get going, you start detoxing much more efficiently and in larger volumes. I have had to increase my B12 injections from 2 a week to 3 a week and I feel very rough if I miss one. This is important - taking high doses of any once B vitamin can give you a deficiency in ther others so it is really important you take a B complex tablet and make sure you are not getting deficient in other B vits. The book describes a hoime test for cortisol levels. You go in a totally dark room adn shine a torch sideways across your eyes. Your pupils will contract, but if you have low cortisol they will then expend again, even though the light is still there, because the muscle cannot sustain its equilibrium. I tested this on myself and lots of healthy energetic people and it really works. I do it every few days and it varies according to how energetic I feel.