Re: can anyone break down the stages of Adrenal Fatigue from 1, 2, 3, and whatever else is b4 dead?

Stage 1: Alarm Reaction (Flight or Fight response)

In this stage, the body is alarmed by the stressors and mounts an aggressive anti-stress response to reduce stress levels. Some doctors called this the Early Fatigue stage.

Typically, there is an increased ACTH from the pituitary gland that stimulates the adrenal glands into full gear to mount an retaliation response. The adrenal medulla is stimulated to secrete more epinephrine, and the total cortisol output from the adrenal cortex is increased from the excitatory stimulus. There is a corresponding reduction in DHEA production. During this period, the body needs cortisol to overcome stress, and production of cortisol is therefore increased. After some time, the adrenals will experience difficulties in meeting the body's ever increasing demand for cortisol.

Stage 2: Resistance Response

With chronic or severe stress, the adrenals eventually are unable to keep up with the body's demand for cortisol. As such , the cortisol output will start to decline from a high back to a normal level, while the ACTH remains high. With protracted ACTH and adrenal fatigue, less cortisol is produced due to the adrenal becoming exhausted. While the morning, noon, or afternoon cortisol levels are often low, the nighttime cortisol level is usually normal.


A phenomenon called pregnenolone steal (also called cortisol shunt) sets in. Cortisol production becomes the predominant pathway of hormone production as the body favors the production of this hormone. Other hormones such as pregnenolone, DHEA, testosterone and estrogen are less favored and their production will decline. As a result, total pregnenolone output is reduced but total cortisol output continues to be maintained at a normal level. Careful analysis of the daily diurnal cycle of cortisol shows a dysfunctional pattern of abnormally low cortisol in the morning. This is a time when cortisol is needed the most. Nighttime cortisol is usually still normal.

Stage 3: Exhaustion

Despite rising ACTH, the adrenals are no longer able to keep up the increased demand for cortisol production. This may happen over a few years. Total cortisol output is therefore reduced, and DHEA falls far below average. The nighttime cortisol level is usually reduced as the hypothalamic-pituitary-adrenal axis "crash" and the body is unable to maintain homeostasis. Severe sex hormonal imbalances (estrogen, progesterone, and androgens) are common and a precursor to adrenal failure.

Stage 4: Failure

Eventually, the adrenals are totally exhausted. Patients at this stage have a high chance of cardiovascular collapse and death.


the above is taken from my article Adrenal Fatigue which you can read in its entirety a here:

https://www.drlam.com/articles/adrenal_fatigue.asp
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