If your doctor isn’t running an adrenal stress index when he hears you have the following symptoms, he or she might be missing a huge part to helping you.

(Here is a complete chart from DUTCH that shows the full pathway of hormones including cortisol)

The ASI is designed to measure saliva levels of cortisol, DHEA, and other hormones. We use Diagnostechs for this test, and there are others out there.

Here’s an example of a normal ASI cortisol rhythm(above).

Cortisol output should be elevated in the morning, and lowest in the evening/night times.

Cortisol is inverse to Melatonin, our sleep hormone. Melatonin is derived from Serotonin, our feel-good neurostransmitter.

Most commonly with insomnia and sleeping issues, you will see cortisol elevation in the evening, because as cortisol elevates, melatonin drops.

Chronic stressors and adrenal fatigue individuals are often lacking total cortisol output (low), or conversion to cortisol from cortisone.

Below you will see a chronically depressed cortisol output. These can occur in individuals with super chronic stress for many years, think work, relationship, infection, emotional traumas etc.

Example #1 Chronic stress, anxiety, toxicity or infection, blood sugar dysregulation etc can cause this rhythm. This could be considered “adrenal fatigue” although some say it doesn’t exist, the functional outcome of someone feeling better is more important than what it’s called.

An individual in an acute stress situation (work, relationship, infection, emotional traumas etc.) will show a cortisol rhythm like the one below. It will often be elevated to an extreme level, and the individuals symptoms will correlate.

Example #2 Severely elevated cortisol levels are considered more of the acute response to stress, anxiety, infection, trauma. The approach to improve this is different than the “adrenal fatigue” rhythm.

The initial presentation may only require a general adrenal adaptogen to help mitigate the acute low-grade stressor the individual is experiencing.

The 2nd LOW cortisol patient requires a full overall, a comprehensive evaluation of labs including, gastrointestinal health, systemic infection, leaky gut barriers, full neurological workup and brain-gut therapies in addition to nutritional and lifestyle support to help increase cortisol levels in the morning, and bring them into normal levels in the evening.

Example of nutritional support for patient #1– Exercise HIIT in the morning to boost cortisol output, possible increase in carb load per meal in the morning, utilization of caffeine in the morning is OK but not ideal. Adrenal stimulating products (we use Adrenaliv from Xymogen FOUND HERE), as well as waking as the sun comes up and exposing yourself to sunlight immediately in the morning. – Example wakeup early and go for a brisk walk mixed with jumping jacks. This activates your CAR or Cortisol Awakening Response (this can be evaluated via urine testing from DUTCH).

The 3rd HIGH cortisol patient requires a completely different support system than the 2nd patient. This individual also needs acute evaluation of history, infection, inflammatory foods, look into relationship and work status, and probe into previous emotional traumas. This individual will require nutritional and lifestyle support to bring down cortisol throughout the day, and this will likely take cognitive behavioral training (CBT) as well as prefrontal and brain-gut axis therapeutic intervention.

Example nutritional support for patient #2– decrease overall exercise load, maybe replace with isometric movements, yoga, pilates, stretching, meditation, tai chi, decrease all alcohol and caffeine intake, change dietary consumption to keto-tarian ie keto dominant with vegetarian focus. Cortisol lowering supplementation (we use Cortisolv and RelaxMax from Xymogen from FOUND HERE), utilizing specific light filtering from devices specifically screen use, limiting screen time to at least 1-2 hours before bedtime (shortly after dark ideally).

(keep in mind, this assumes you’ve already addressed all issues found in a comprehensive blood analysis)

If you or anyone you know falls into any of these categories, please send them our way so we can get them some help.

**Make sure to assess all other components of gut, infection, thyroid, blood sugar, inflammation etc before embarking on a supplemental/nutritional program**