On an AM cortisol my adrenals look fine. On 4 point adrenal saliva test, I'm flat-lined on all 4 points (and have been for many years). I don't do that well with stress. I had doctor warn me about how dangerous this was, how it was among the 4 worst profiles they had ever seen, blah blah blah.
I've tried all kinds of adrenal supps and don't tolerate any of them, even in extremely tiny amounts - they're all too overstimulating. I would be scared to death to try Cortef. I was prescribed something like that (can't remember the actual name) but didn't take it either.
So for many years, I supported my adrenals by doing homemade electrolyte drinks. That would be salt, vit. C, and magnesium for me. Others might also need potassium or other substances. The adrenals regulate electrolyte imbalance, so if you have poor adrenals, you'll be losing these electrolytes like crazy. The drink will make you feel a lot better.
Fast forward to a month ago. I've been working on methylation. Within a few months my thyroid (formerly hypothyroid), went hyperthyroid and I had to discontinue my medication. During the same time, my need for the electrolyte drink was reduced in half. So the methylation is really helping my thyroid and adrenals. I should be able to get full recovery of the adrenals, and ditch the electrolyte drink eventually, but I need to continue to go very slow with methylation.
One point about adrenal fatigue - I think for many of us, we have "apparent" adrenal fatigue, not actual adrenal fatigue. Our brand of adrenal fatigue is caused by loss of signaling to the thyroid and adrenals by the hypothalmus and pituitary, not by any actual failure on the parts of these organs. The loss of signaling is caused by glutathione depletion.
So you restore methylation, build up glutathione, and voila, your thyroid and adrenals start working again. Rich Van Konynenburg talked about this.
This would also explain why we don't tolerate adrenal glandulars, as our adrenals are not actually fatigued. It will look the same either way on an adrenal saliva test, so it's misleading.
Hmmm, it just occurred to me that may also explain why your adrenals would look fine on an AM cortisol, while looking terrible on an adrenal saliva test, and maybe that's a way to tell which kind you have...just speculating here.