Adrenal Fatigue by Dr James Wilson – Book Review #adrenal #adrenalfatigue

Adrenal Fatigue by Dr Wilson – Book Review

People diagnosed as bipolar often end up suffering from chronic fatigue. I wanted to understand how this may relate to poorly functioning adrenal glands, so I researched on-line, talked with nutritionists, experimented with my diet and read two chunky books about Adrenal Fatigue. This book, simply called Adrenal Fatigue is for me the better of these books.

Adrenal Fatigue covers everything you might want to know, including recognizing adrenal gland problems, blood and saliva tests, adrenal fatigue book dr wilsonwhat adds up to causing the problems, why adrenal function is often not being recognized, how the adrenal glands function and what to do to feel well again.

I was amazed at the strength of opposition from drug companies, most mainstream doctors, endocrinologists and health services (such as the UK’s NHS) to the phrase Adrenal Fatigue. The official line from all these people is that adrenal glands cannot be fatigued, with only extreme adrenal dysfunction being recognised and considered treatable. The extremes are; Cushing’s-Syndrome, where the adrenals produce far too much cortisol and Addison’s-Disease, where the adrenals produce far too little. Both of these extremes are said by mainstream doctors, and perhaps crucially by insurance providers, to be unrelated to the fatigue that millions suffer. Most doctors are unable to react to test results that show the adrenals are not at peak performance as their training is that this does not need any medical response.

Dr Wilson (who was the first to use the phrase Adrenal Fatigue) along with a significant minority of doctors and nutritionists around the world, is saying we need to pay more attention to our adrenal glands. How well our adrenal glands are able to work depends on many factors whilst changes in lifestyle can get most people who are suffering from fatigue back to something like their normal selves.

Perhaps the oddest thing about this conflict between Dr Wilson’s supporters and the established health services is that the latter recognise a condition called Adrenal Insufficiency, which they say has nothing to do with Adrenal Fatigue – even though it has EXACTLY THE SAME SYMPTOMS! Maybe this disagreement is just about the label and really it makes no differences whether years of stress and poor diet have caused our adrenal glands to be fatigued or insufficient. Either way, it feels real when you find yourself having to go to bed (or in extreme cases just lie down on the floor, unable to even walk to a bed) in the middle of the day.

What I have learned from the book, which is supported by strong evidence and many experts other than just Dr Wilson?

  1. The approved saliva test is well established and does indeed give a good indication about how your adrenal glands are working during the day of the test.
  2. Although improving diet and gradually doing more gentle exercise will almost always help, having fewer stressful events/fewer stressful days will make the biggest difference and allow for the most rapid recovery.
  3. The book’s recommendations for dealing with adrenal fatigue are so closely related to what is known to be good for general health and fitness that following Dr Wilson’s advice will improve almost anyone’s health, regardless of your beliefs about adrenal fatigue/insufficiency.  The book is full of good health advice.
  4. The scientific part of the book is good science and matches well with the chemistry I learned when completing my BSc many years ago. Facts such as the adrenal glands convert cholesterol to cortisol in order to help you cope with every day stressors and have any energy at all are indisputable.

Did Dr Wilson’s book help me?

Yes, definitely! While reading the book I made some small dietary and lifestyle changes. These have allowed me to have more energy and to have that energy for more hours per day. This is not the same as cured but it could well be that I am on a good road of recovery from the extreme fatigue (Chronic Fatigue Syndrome) I was suffering from.

How did the book help?

There are lots of ideas in the book that all helped a little. It was useful to be reminded that I need good healthy fats to make enough cholesterol to allow all the other hormones to be made as needed. Without eating healthy fats everyday our adrenals are going to struggle

The idea that made the most difference for me was almost the simplest in the book and is in some ways so obvious that my GP, and all the other specialists I have met with, missed it. Dr Wilson does not make a fuss about stress and poorly functioning adrenals causing sodium depletion. He just states it, as a well-known fact. However, this led me to look closely the records I had made for my nutritionist about the exact amounts of every food and drink I consumed on many days during 2013. It turned out that without eating processed foods (such as bread, cakes and takeaways) I was not having anywhere near enough sodium in my diet. Meanwhile by eating fruit, nuts and generally a lot of things I felt would be good for me I had increased my potassium intake.

The net effect of low sodium and high potassium was that I was suffering variable and often very low blood pressure. By monitoring my blood pressure and gradually increasing my sodium intake up to the UK’s recommended daily amount, I feel I have twice as much energy and half as much fatigue, just through that one change. An example of this: after moving house my washing machine just sat in the kitchen unconnected as I did not feel able to even attempt to move it to plumb it in. After just two days with a little extra sodium (half a teaspoon of sea salt) I moved the machine and plumbed it in as if I had never a fatigue disorder.

Were there ideas from Dr Wilson that may not have been so good?

I could not see anything wrong or illogical in Dr Wilson’s work. However, I am not convinced about Dr Wilson’s supplements. A friend bought me a bottle and I took one a day. I cannot say that I took these long enough or enough per day to say whether the tablets were useful or not. After a few weeks I did not like the smell of the tablets and stopped taking these. Being meat based I wonder if this supplement might be of greatest benefit to those who do not normally eat much meat?

Overall, I am going to say, that if you have any interest at all in how people can be less fatigued this is essential reading and I highly recommend ‘Adrenal Fatigue – The 21st Century Stress Syndrome’ by Dr James L. Wilson.

Roger A. Smith, Rethinking Health Ltd

Bipolar or Adrenal Fatigue Part 1 of 3

Bipolar or Adrenal Fatigue

There are many causes of variable energy levels. If you used to be OK and now you are not so OK, you may be wondering what is going wrong.

How you describe your struggles can make a huge difference in how you recover and get back to something like your usual self.

I am only just starting to study Adrenal Fatigue, so bear with me as I make tentative efforts to show the similarities and differences between this and bipolar disorder diagnosis. I intend to come back to this article and make it more detailed and precise as I learn more about Adrenal Fatigue. In fact I am going to publish this only part written and add to it bit by bit when I have the energy to do so.

Similarities and differences:


  • Both diagnoses involve changes in energy level
  • Adrenal Fatigue is likely to affect you to some extent every day until you deal with whatever is causing it. Bipolar disorder is said to come and go and is said to allow you to have days that are symptom free. If you are running out of energy during daylight hours when you did not used to run out of energy then this is likely to be related to poor functioning of the adrenal glands.
  • If you are suffering from Adrenal Fatigue you are likely to have or seem to have periods of higher energy as you are likely to need to be very busy while you do have energy to catch up for when you do not have energy. If you have Adrenal Fatigue and are not dealing with it then you will find these periods of higher energy get shorter and perhaps less frequent. The bipolar diagnosis does not necessarily predict shorter and less frequent high energy periods.


  • There are no medical tests for bipolar diagnosis. Bipolar disorder is a psychiatric label that covers a range of physical and psychological troubles. It cannot be detected by brain scans or blood tests. Bipolar is diagnosed by observing someone who appears to have variable moods and involves asking questions of that person, their family and people who come in contact with them. To a psychiatrist or similarly informed doctor anyone with Adrenal Fatigue could be thought to have bipolar disorder.
  • Adrenal Fatigue blood tests – The adrenal glands produce cortisol and a hormone (maybe technically better described as a hormone precursor) known as DHEA. The adrenals produce the ideal level of these chemicals to match your body’s requirements. Both these naturally occurring chemicals can be detected in the blood. The level detected in a blood sample gives a snap-shot of how your adrenals are working. Exceptionally low levels are associated with Adrenal Fatigue. However, you and your doctor need to know the time of day the sample is taken as cortisol and DHEA vary throughout the day.
  • Adrenal Fatigue saliva testing – Cortisol and DHEA are small molecules that travel to all parts of your body including the saliva glands. The test involves spitting in a sample tube and this being sent to a laboratory for analysis. With no need for syringes and needles this test is relatively inexpensive. The main advantage of this test over blood tests is that it is easy to take several samples in one day and with less stress than making a trip to your GP for blood to be taken. How the cortisol and DHEA vary during the day allow a precise measure of how your adrenals are working and it only takes one day of testing to confirm your level of adrenal fatigue.
  • I will repeat here that there are no medical tests for bipolar disorder. If you suspect you may be diagnosed with bipolar disorder a good option is to ask for a day of saliva testing just to be sure your symptoms are not related to Adrenal Fatigue.

If your adrenal glands cannot produce enough cortisol quickly enough you will struggle with all situations that you find stressful. With insufficient cortisol you will be displaying all sorts of symptoms of Adrenal Fatigue that match symptoms of bipolar diagnosis.

  • Sleep pattern: Variable and seen as problematic for both bipolar and Adrenal Fatigue
  • Need to lie down during daytime – only said to happen during depressed phase of bipolar. With Adrenal Fatigue this is going to be happening most days unless you are consistently stimulated – perhaps having a demanding daytime job, so have to keep going and then collapse in the evening.
  • Irritability – You need a good level of cortisol to be able to cope with annoying people and without enough you will react in a way that ‘bipolar people’ are said to react.
  • Concentration – same as bipolar.
  • Pessimism, periods of feeling hopeless/helpless, negative thoughts and feelings – all the same as bipolar.
  • Reaction to stimulants such as caffeine – as for bipolar
  • Appearance – likely to be over-weight or under-weight with a tendency to lose weight when not taking sedatives, such as ‘antipsychotics’ / ‘antidepressants’ / ‘mood stabilizers’. Often looking tired – as for bipolar
  • Development of food intolerances – as with bipolar this may be several years after diagnosis.


  • As with bipolar lifestyle changes, such as; what you eat, what you drink, what drugs you take and avoid, who you spend time with, the time you go to bed and so on, will decide the course of the disorder.
  • In general, bipolar disorder diagnosis (in the UK at this time) results in a lifetime of medication. Adrenal Fatigue rarely requires any drug treatment and recovery usually involves finding ways of living with minimum use of drugs.
  • Treatments for bipolar will in the long run make your Adrenal Fatigue worse.

I have typed all the above without reference to any text books or on-line articles. There may be errors. I am going to publish this as blog on in this rough draft form, as I think it is such an important debate that needs to happen. Are millions of people whose adrenal glands struggle to cope with the modern world being diagnosed as bipolar, and not being given advice on how to look after their glands and feel less stressed?

Bipolar or Adrenal Fatigue – Part 2 – Diagnostics #adrenal #adrenalfatigue #bipolar

Bipolar or Adrenal Fatigue – Part 2 – Diagnostics

We can come to believe we have bipolar disorder by going down a check-list and finding we match just about all the symptoms.

Adrenal Fatigue has similar check-lists such as Dr Wilson’s Adrenal Fatigue questionnaire:

If you are living a busy stressful life and unable to relax you will most likely get a high score on both bipolar and adrenal fatigue check-lists.

My scores indicated severe Adrenal Fatigue, which makes sense considering what I been through and my lifestyle. However, are quizzes like these truly diagnostic? They do not tell us much about the causes. Our responses are based on our own feelings and not precise measurements.

With bipolar this is all we have. It is not possible to scientifically diagnose anyone with bipolar as there are no blood tests, brain scans or anything like that for bipolar. There cannot be as bipolar is simply a word used for anyone who has extreme struggles with their moods, regardless of why they are struggling.

Adrenal Fatigue differs from bipolar: Accurate laboratory based tests for adrenal function/dysfunction have been available for decades.

  •  Adrenal Fatigue Saliva Test: The adrenal glands produce hormones including cortisol and DHEA. These small molecules travel to all parts of your body including the saliva glands. The test involves spitting in a sample tube for laboratory for analysis. This is better than blood tests as it is less stressful and allows for several samples in one day. It is how the cortisol and DHEA vary during the day that allows the precise measure of your adrenal function. One day of testing will confirm your level of adrenal fatigue. Results are provided as a graph, showing changes throughout the day.

My adrenal function test results from April 2013 – click image to see it enlarged:


Adrenal function test results

Cortisol is naturally high in the morning and decreases towards bedtime. If it does not start high enough or drops too rapidly you have most likely got a problem.

DHEA is so central to hormone production that a good level of this is needed at all times. Low results indicate lifestyle changes (perhaps better diet and more rest) are needed.

This test may be better described as a test for Adrenal Dysfunction as the test tells us about how our adrenal glands are performing rather than being directly related to how fatigued you are feeling. Adrenal dysfunction means your energy levels stop matching what you need and when you need it. Dysfunction eventually leads to fatigue.

What does all this mean?

  1. Nobody, not even you can prove you have a disorder called bipolar.
  2. Doctors can measure and say for certain how your adrenal glands are performing and if under-performance is affecting your mood.

If you have been diagnosed/labelled with bipolar, schizophrenia, depression, chronic fatigue syndrome, M.E. or similar then ask your doctor about having your adrenal glands tested through saliva testing. If your doctor says, “No” then consider paying for this test. I think it cost me about £80. If you want me to look up exactly what I paid and where I had the test done, then contact me through the comments option on this blog or through

Bipolar or Adrenal Fatigue – Part 3 of 3

There are many conditions that lead to bipolar diagnosis. Adrenal dysfunction is just one possibility as discussed here in response to a member of the Institute of Optimum Nutrition.

Thank you for your useful contribution to my comparison of adrenal dysfunction with bipolar diagnosis.

Poor diet is one of the main causes of mood disorder, so the link to the Institute of Optimum Nutrition is going to help a lot of readers. The nutrients mentioned are all important and as you know there is a lot more about our diets that need to be taken into account. Moving on from a bipolar diagnosis will involve dietary improvements as part of a recovery plan.

In saying adrenal fatigue is mistakenly being diagnosed as a psychiatric disorder I was very much thinking all forms of bipolar other than the old manic depression diagnosis that involves people getting extremely busy, having grandiose plans and as you say, “have enough energy to rush around.” This state is described as mania and may also involve noticeable loss of touch with reality, with delusions and/or hallucinations.

In the more modern forms of bipolar, which are now by far the more common diagnosis, there is a much closer match with adrenal fatigue. With the Bipolar 2 diagnosis the patient has long periods of low energy and negative feelings, with short-lived periods of having a little more energy often not even noticed by friends and relatives. With another form of bipolar called cyclothymia the periods of low mood are not usually disabling but just keep on happening, and again without any extreme highs.

What I have noticed is that like me, people may initially see a doctor when having plenty of energy and asking for help, but after several years of involvement with psychiatry the high energy periods become shorter and less extreme until the pattern of moods looks more like on-going fatigue.

I am sure we are agreed that Adrenal Fatigue is best not described as a psychiatric disorder. I am hoping is that my articles will remind doctors that there are many reasons for apparent mood disorders. The other imbalances you mention (hormones, nutrients, food intolerances, blood sugar) do cause imbalanced moods and do need to be addressed first along with external stressors.

Most people who start off appearing to ‘be bipolar’ eventually end up fatigued and coping with exhaustion becomes our biggest daily challenge. (As discussed elsewhere sedative psychiatric drugs can cause more fatigue.)

Too often a bipolar diagnosis is given without looking for other possible causes. Adrenal Fatigue is just one of these possibilities and there are many more that I wish could be checked out before psychiatric labels are considered.


%d bloggers like this: