I have had a few trials of treating adrenal fatigue from different angles and different doses. Im starting to notice a benefit from treating adrenal fatigue but i have also been treating other ongoing issues but i thought i would list a few things that i have found through my experience as well as from what i have read. First i will say that i think adrenal fatigue can be measure by low dhea levels and or low cortisol. The worse your adrenals are the more likely to have an adverse reaction to treating them with 'normal' recommended doses of adrenal hormones etc I also think one has to start with slowly increasing dhea levels first before trying to increase cortisol through use of pregnenolone or hydrocortisol or glandulars. I currently have my dhea to a normal level and now when i use a small amount of pregnenolone that i have in the past, i dont get overstimulated by it like i once did. I think dhea helps counteract any negative aspects of increased cortisol levels one might get from pregnenolone. I found before having normal dhea i would get over stimulated by even low doses of preg, this doesnt seem to be happening now. Transdermal creams i think at the same dose are stronger then dhea or pregnenolone in pill form but not neccessarily better, maybe it works through a different pathway or metabolised differently. In men dhea can change/aromatise to estrogen so sometimes another product is need to stop this. I found low doses of arimidex very effective for this at 1/2mg twice a week. Men do better off keeping estrodiol levels within the lower 1/3 of the range. This also helps with losing weight. Most info on dhea refers it to a hormone that is used to make testosterone or estrogen. I think it has other aspects in its own right that arent really known. I think it helps with negative effects one can get from cortisol. And i also think it can help improve sleep through lowering inflammatory cytokines that are known to worsen sleep. I have been able to reduce my sleep med doses and i seem to be getting a better quality of sleep, i still get the odd bad night but on average things are improving in the sleep department. Also feel stamina has improved some. Normal recommended doses of dhea and pregnenolone are around 25-50mg per dose. I think many of us need to start at 5-10mg of dhea and slowly increase this until dhea levels are at the middle or upper third of normal range, then look at adding pregnenolone in doses of 5-10mg maybe upto 25-50mg depending on how one feels and what tests show. Once i was on the right track i started supplementing with dhea at 10mg a day and stayed at this dose for several weeks before increasing it to 20mg and stayed there for a few months and i am now on 25mg a day of dhea for the past few weeks. This has brought my low dhea level up from 2.1 to 7.1(normal 2.2-15.5). So i have increased my dhea dosage very slowly, in the past i have started at 50mg and ended up overstimulated and feeling like crap. Now i plan on trying to increase my cortisol levels abit more with pregnenolone to help with inflammation and joint pains from this. I have been using a dose of less then 5mg a day with no overstimulation like in the past, actually no changes at all but this could be because of the very low doses, but slow and steady wins the race. I feel dhea is helping reduce any problems with preg/cortisol. Im not sure how higher dose of preg i will go, at this stage just enough to help joint pains, crunching feeling like sand in my joints eases up. I think this will also help improve energy and recovery levels and hopefullly my immune function as i would like to be able to come off antivirals and antibiotics one day and i need my body top be running smoothly. I will say that this is still a work in progress and improvement has also come from antivirals and antibiotics for sinus issues. I dont think i could really single one thing out. Normally i would be wiped out when my working week is over and usually with a sick day taken amongst it, my days off would be spent doing nothing but resting in bed. Now when on days off i have been able to get into a few thinks that need doing around the house, also doing some very short, light workouts. Im not pushing myself to the limits but i am slowly expanding my boundaries. I think treating adrenal fatigue is apart of the puzzle of cfs that can help us to improve, married up with infection killing and immune boosting therapies as well as symptom management like sleep meds etc cheers!!!