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1. What are the symptoms of adrenal fatigue?
2. Is there differences in presentation between the sexes?
3. What to look for in you?
4. What are some of the things you can do to combat this?
5. What is the prognosis and how long can it last?

Do you have dark circles under eyes? Are your eyes sunken to some degree? Do you sleep poorly? Have you lost your energy? Sex drive gone? Do you bloat and start getting unusual bowel movements? Do you live in a plateau phase constantly? Has your weight remained the same too long? Tired for no reason? Need to drink a ton of coffee and salty carb snacks to get by? Do you still crave sweets? Do you feel generally rundown? Do you exercise a lot but still have belly fat that is resistant to loss? Are you forgetful often? Hair loss or brittle? Diagnosed with GERD (dysbiosis) and feel nervous often? Often depressed? If this sounds like you welcome to the diagnosis of adrenal fatigue. Many conventional docs don’t buy this diagnosis but that is because they can’t see what they are not looking for.

This syndrome is most often seen in middle age women and can present with multiple endocrine changes that are often confused with thyroid issues or perimenopausal changes. Men do get this syndrome and most often it is seen with dietary issues and fatigue from working out or from chronic stress.

What to look for in you: People with adrenal fatigue tend to wake up tired (low cortisol) and not wanting to eat breakfast. Most people don’t have enough fuel in their livers/muscle for gluconeogenesis to sustain the day’s needs. In this scenario if you don’t eat you are basically stressing your adrenal gland further to sustain sympathetic tone to make that energy your liver does not have. You are demonstrating poor post workout recovery. You get sick more often and your recovery from illness is slower. Usually you have bloating and signs of a leaky gut and poor immune function. Your nails will be brittle and your temps might fluctuate. Your vitamin D level falls for no reason. You will also have a lower BP and tend to feel cold most of the time. Heart palpitations and chest pain are possible as well. Women will have more premenstrual symptoms and will notice more food intolerance over time. Sometimes a contributor is emotional stress in the history. Divorce, cheating, spousal death/disability are huge drivers of this syndrome. Hypoglycemia is very common especially with activity. In women, I look for (OAT) ovarian, adrenal and thyroid syndrome that have symptoms such as PMS, low body temperature, endometriosis, PCOS, cystic breast, menstrual irregularities, fibroids suggestive of ovarian dysfunction and Estrogen Dominance; dry skin, weight gain, fatigue, low energy, blunted response to thyroid medications suggestive of secondary hypothyroidism; salt craving, frequent infection, hypoglycemia, insomnia, anxiety and adrenaline rushes suggestive of sympathetic overtone common in late stage Adrenal Exhaustion.

Stressors that can lead to Adrenal Fatigue include:

  • Emotional stress
  • Chronic fatigue
  • Chronic illness
  • Chronic infection or autoimmune disease.
  • Chronic pain and opiate abuse
  • Depression
  • Excessive exercise
  • Fear and guilt
  • Gluten intolerance
  • Low blood sugar
  • Malabsorption due to lectins and phytic acid
  • Dysbiosis
  • Toxic exposure to environmental stressors (Hg)
  • Severe or chronic stress
  • Surgery of any type
  • Late hours for any reason
  • Sleep deprivation or night time shift work
  • Excessive refined sugars in diet
  • Excessive caffeine intake from coffee and tea
  • Chronic dental infections of periodontal or endodontic etiologies.
  • Microcytic anemia due to copper deficiency complicated by low zinc levels.

Diagnosis: A good History and Physical is invaluable to make the diagnosis. Look for salivary cortisol levels in the AM to be very low and a reverse of the normal diurnal cortisol cycle. Patients tend to have low sex steroid hormones and flat to lower vitamin D levels and especially low DHEA levels. This is in fact my favorite lab to diagnose this condition. Total lack of sympathetic response due to low epinephrine and norepinephrine. I check this with bio-impediance (BIA) and heart rate variability loss. BIA shows a reduced phase angle on exam. HRV is diminished with testing. Patients also have low aldosterone levels and this is why they always have low BPs with increased thirst. The person who “quantifies” themselves with lab values will be able to diagnose themselves rather easily with a few key labs. A very positive history of dysbiosis. The dysbiosis is die to reduced secretory IgA (the main cellular defense factor), natural killer (NK) cell and T-lymphocyte activity which lead to increased chances of getting infections such as Herpes, yeast overgrowth, and viral infections.

Treatments: Adaptogens Maca, Rhodiola, Holy Basil, Black cohosh root, licorice, Fo-ti root

Supplements: CoEnQ10 (ubiquinol) 400mgs to 1200 mgs, phosphatidylserine and choline, DHEA and pregnenolone replacement (all based upon lab values)
Treat with high dose B complex and vitamin C replacement to help liver detoxification phase 1 and phase 2 pathways

  • Introduction of Mind body meditation techniques in my view is critical to getting better.
  • Big thirst is a big symptom. Treat with hydration and salt tabs.
  • Astragalus (Qi-tonic or TA-65)
  • Melatonin
  • Progesterone
  • Complete darkness for sleep
  • Bioidentical cortisol (hydrocortisone)
  • Oxytocin (natural secretion is better than exogenous forms)
  • Colostrum
  • Replace vitamin D to minimum 50 ng/dl
  • GABA replacement
  • L-theanine (copiously found in green tea)
  • Avoid caffeine, chocolate, ephedra, guarana, kola nut, and prescription stimulants. (Ritalin)
  • For severe cases check Zinc and Copper levels as well. Fe levels and Hg levels in long standing cases
  • Expose yourself to low light situations as soon as the sun sets before bed

Pearls for a Adrenal optimization:

  • Sleep by 10 PM
  • Sleep in until 8:00 AM
  • Avoid over training
  • Do the things you enjoy
  • Avoid coffee or other caffeinated beverages; steep your tea!
  • Eat early within thirty minutes of rising
  • Have a glass of water in the morning with 1/2 to 1 teaspoon of salt
  • Avoid grains such as bread
  • Avoid starchy foods such as potato
  • Mind body mastery/ Laugh several times a day
  • Take vitamin C, pantothenic acid, magnesium, and vitamin E (Mixed tocophrenols)
  • Take pregnenolone and DHEA, as needed
  • Avoid becoming fatigued
  • Avoid high glycemic fruits
  • Never skip breakfast ever

PROGNOSIS: is usually excellent

Treatment with recovery time takes anywhere from 3-18 months depending upon severity of the condition at presentation. The most serious cases usually have dietary causes intertwined with several mineral deficiency and an uncorrected hormone imbalance.

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  1. Tim July 8, 2011 at 9:31 am - Reply

    I think this blog will be pasted on every paleo forum quickly! I notice so many levees depend on Vit D. When Vit D labs are taken, the results are given as:

    Vitamin D, 25 OH

    Vitamin D, 1, 25 (OH)2

    Vitamin D3, 1,25 (OH)2

    Vitamin D2, 1, 25 (OH)

    Which are the most important to keep in check? And is low Vit D a precursor to adrenal fatigue or a symptom of?

    Thanks for the great information.

  2. RachelZoe July 8, 2011 at 10:31 am - Reply

    This sounds a lot like me. I've been having extreme fatigue, accompanied by deficient levels of Vitamin D (14) that improved to low levels with supplementation (28). I've been having anxiety, depression, problems sleeping, insomnia, and extreme thirst. I've been in counseling for four months to deal with issues related to an abusive marriage. I am gluten intolerant and stopped eating all gluten grains about a year ago. Coffee is the one thing that makes me feel better anytime of day or night, lol. I'm going to start incorporating some of these ideas into my leptin reset as they all make sense to me. Thanks for the post.

  3. meredith July 8, 2011 at 11:06 am - Reply

    I didn't see this listed as one of the symptoms but I wonder it this is linked – broken facial capillaries. I cannot for the life of me find the the culprit. I don't drink, I don't eat refined carbs (actually I am pretty low carb) I take resveratrol, grape seen, quercetein, bromelain, vit c, vit D and b complex. I keep thinking this is adrenal/cortisol related, I just can't pin it down. THanks!

  4. Jack July 8, 2011 at 11:52 am - Reply

    At Meredith……broken capillaries have many etiologies…..most common one I see is high cortisol not low and higher estrogen. In fact in men its the number one reason for them. They tend to be aromatizers from the conversion of testosterone to estrogen. In women its more of a hormonal imbalance that causes them. I usually recommend women get a full hormone panel done to see if something is awry for that problem when the low hanging fruit is already picked.

  5. K in Az July 8, 2011 at 9:00 pm - Reply

    Been waiting for this subject….thanks! For people with adrenal fatigue, do you still recommend three meals per day, no snacking? Carb level recommendation?

    I had my cortisol saliva test done & show low cortisol levels morning, noon, and afternoon, but high at night…the opposite of what I want! I've done most of what you recommend in this blog, but am doing 5 meals per day thinking this would help with my hypoglycemia. Is this not the case? My carbs are around 50-125 grams based upon reading Diana Schwarzbein info…this is much higher than your leptin reset protocol. Confused as to which approach is best for both adrenal fatigue & hypoglycemia.

    And thank you for devoting your time to this! So glad to read information coming out about these issues that seem to be dismissed by most MD's!

  6. Jack July 9, 2011 at 1:52 pm - Reply

    With adrenal fatigue you can eat more than three meals but I recommend three with different macros…..if you add back the carbs and see no change in two weeks you back off the carbs and redirect your clinical efforts to other options that will be more effective based upon the current clinical situation and labs. This is a question that requires seeing a clinician that knows how to treat it.

  7. Jason July 10, 2011 at 10:23 am - Reply

    I have used a golite (intense blue light device) to reset my sleep patterns. If I use it in the morning, the next day I will wake up at about that time.

    I have also used orange tinted sunglasses in the evening to help me get to sleep.

    So, it occurs to me that the color of light the eye sees may affect the hormones in the body. Do you have any comment on that?

  8. Dawn July 12, 2011 at 11:51 am - Reply

    I recently read that adrenal fatigue was actually a brain problem because adrenals are just glands that respond to the stimulus they are given. Unless you have Addison's, if your adrenals are not secreting hormones properly, then they are simply not getting the right signal to do so from the hypothalamus. Therefore, treating adrenals with adaptogens, etc. is basically just treating symptoms and not the root cause of the problem. What do you think of this?

  9. Jack July 12, 2011 at 2:03 pm - Reply

    @Dawn. This is something I hear often from many doctors as well. It is a fair criticism in my view but once you see the clinical results of treating this condition you gain a different perspective. I do agree that I think most problems with cortisol start in the brain. And if you read how I suggest we treat this you will see using meditation is a huge factor. I use this technique personally myself every day to deal with the stressors in my own realm.

  10. Jack July 12, 2011 at 2:04 pm - Reply

    @Jason I am aware of those lights and have read some papers about them but I have no experience using them clinically. It certainly sounds like it has biologic plausibility and if it helps you i see no down side.

  11. Dawn July 12, 2011 at 3:43 pm - Reply

    The number one factor in improving my own severe adrenal fatigue has been specifically Holosync meditation. In fact, it has had such a profound effect on my recovery, I am starting to speculate that adrenal fatigue/CFS is, in a great many cases, MOSTLY psychological stress so profound as to cause massive physical degeneration and imbalance, which in turn adds to the psychological stress and imbalance in a vicious cycle. Throw in a crappy diet and a bad habit or two, and you have a recipe for serious break down.

    With Holosync meditation, the binaural sounds you listen to as you meditate entrain the brain to alpha, theta then delta waves, basically inducing a state meditation on the brain, even if you have chronic monkey-mind and wiggle-butt and can't meditate to save your life. It actually helps rewire the stress response in the brain. The panic attacks I was getting with severe adrenal fatigue disappeared the first two days I used it. Lots of clinical evidence behind it. I think as a neurosurgeon, you would find the technology very interesting.

    The importance of stress-relieving mind-body therapies in treating adrenal fatigue and CFS CANNOT be overstated or overestimated.

  12. Jack July 12, 2011 at 4:13 pm - Reply

    @Dawn. While I agree with most of what you write let me take issue with one stereotype every one makes with AF treatment. Many people refer to it as the "mind body diagnosis". I reject that. The brain is an organ that creates consciousness and that consciousness effects changes by using neural outputs and hormone signals. It is as if we discount the mind when we mention mind body Rx's as some sort of new age medicine. Do we do the same to the heart? Do we discount the conduction system in the heart? No we dont. I long ago lost this separation of the mind and body. The brain controls everything in our body to some degree. Anything that allows our brain to bring us back into to some control or balance is an organ effecting control over its homeostasis. So I dont believe in a mind body separation. The mind releases thoughts, and those thoughts become "thought hormone" that exerts some control over our homeostasis. That signal is transduced by our adrenal glands into hormones that can effect the cells. From that interaction comes the action the brain wishes. That is precisely how I see adrenal fatigue as neurosurgeon. On many forums I have said we can change our DNA with a thought. This is precisely how it occurs and how we can effect our own epigenetics with our thoughts.

  13. Dawn July 12, 2011 at 5:21 pm - Reply

    I think because so much of the stress that causes conditions like AF has a deeply irrational, emotional or psychological component (you mentioned divorce, infidelity, etc.), it is easy to discount or relegate to the realm of the "psychosomatic" or, at worse, chalk up to "women's problems." Antidepressants and HRT are standard (ineffective) allopathic treatment for CFS and adrenal fatigue symptoms!

    Feelings are messy, not scientific, so they couldn't be relevant, right? Or if we speculatively admit there might be a connection between thought and health, we tepidly call it "mind-body," and we pity (or worse, totally condescend to) those "poor sensitive souls" who let their feelings affect their health.

    You must know, Dr. K, that it is not in any way part of common understanding that thought could change DNA, that thoughts and feelings are somehow "things" exerting influence over more than we ever realized. That we could actually become truly response-able for–even creative with–our own health and well-being. That's quantum stuff. 🙂

    No doctor I know has the basic understanding, much less the guts to say, in essence, "Your husband cheated on you (or fill in the blank) and your angry, sad, frightened feelings about it are so intense that, in the absence of counterbalancing mechanisms, they are breaking you at a cellular level." Except maybe you. Thank goodness, and thanks for writing this.

  14. Jack July 12, 2011 at 9:51 pm - Reply

    You do know that levee thirty in the quilt will cover quantum biology? The quilt is meant to tie all my idea together. And quantum biology plays a huge role. It plays a monster role in the organ I operate on all the time. Consciousness is a function of the brain born of quantum biology. Most doctors have no idea about how this works but I can tell you ever surgeon sees it daily when an anesthesiologist puts a patient asleep in surgery. I am sure that levee will make people scratch their heads when I get to it. Quantum biology and Fractal geometry are a huge part of cellular homeostasis. Medicine is 25 years behind what is being found in research labs in this area.

  15. Exceptionally Brash July 14, 2011 at 4:51 pm - Reply

    What is your viewpoint on Dr. Schwarzbein's recommendations for people with both IR and adrenal issues? She believes that going on a low carb diet to fix IR can lead to adrenal fatigue, and so recommends structured meals and snacks and an absolute minimum on carbs for each mini-meal.

    Her minimum carb amount seems to be 60 g, carefully spread out through the day, compared to your 25-50 g recommendation, loaded onto the later part of the day with no snacking.

    Can you be more specific about adding the carbs, and then backing off? How high to go, when to eat them, etc.

    Thank you in advance.

    • Jack July 14, 2011 at 5:46 pm - Reply

      If your IR you have type two DM and your cortisol is elevated not crashed. If you read my Hormone 101 post I make an axiomatic statement that LR leads to IR and winds up with high cortisol. That being said with long term or poor dietary controlled diabetes you can burn out your adrenals. advocating carb use in a diabetic in my view is not a good one. And I dont.

  16. Bill July 15, 2011 at 10:47 pm - Reply


    You recommend GABA in this post.. is there any issue with messing with GABA receptors and down regulation like there is with melatonin?

  17. Jack August 28, 2011 at 6:51 pm - Reply

    @Bill it can happen.

  18. deeze August 31, 2011 at 1:51 am - Reply

    Dr Kruse,

    Thank you for this blog entry!

    What are the more probable causes of AF-like syndromes in males in their early 20's (mine started at the age of 20; 2 years ago and persists to this day). I thought it was due to excessive weight exercise, which i stopped and yet no resolution of symptoms within 2 years. I never starved myself, instead ate tons of food ~3500 cals a day, down to 2000 daily now, with alot less exercise.

    My bodyfat is 10% or lower, i am and have always been very athletic yet my performance has gone down by at least 30-40%. Terrible endurance both cardiovascular and muscular. Energy is always Okay in the evenings, terrible early mornings. "inner" anxiousness is a big thing…

    Sort of seems like im stuck in some sort of inflammatory cycle that doesnt want to yield, problems are compounded by the fact that i live in Canada where there is no Reverse T3 nor pregnenolone testing.

  19. Michelle September 5, 2011 at 8:38 pm - Reply

    Oh. Okay. This is me right now, I guess. I've been off the steroids for 3 months and I guess I'm still not 100% then.

    The weight loss plateau is killing me. I'm working so hard and nothing nothing nothing.

    I think I'm showing some signs of recovery. Maybe. My body literally heats up after eating food and I've avoided IR type weight gains after carbs due to the metabolic furnace thing, which has been a completely new pattern.

    But no loss. No matter how paleo I go.

    *bangs head on wall*


  20. Jack September 17, 2011 at 2:17 pm - Reply

    @Pic When you get dizzy from standing up, getting out of bed, or going to the john this is called orthostatic hypotension and is usually die to a lowered cortisol level. You can diagnose it from a salivary cortisol assay.

  21. myak September 21, 2011 at 8:14 am - Reply

    What do you think about taking a 30-60 min nap in the afternoon for people with adrenal fatigue? Can a nap interfere with recovery?

    • Jack September 22, 2011 at 1:47 am - Reply

      @myak Sleep is good anytime.

  22. kerri h October 21, 2011 at 4:42 pm - Reply

    Thank you for your very useful blog! I stumbled on it today, and am taking your suggestions for adrenal fatigue.

    I have narcolepsy, off-rhythm cortisol levels, hypothyroidism, and I am 30 lbs overweight. I know that eliminating sugar and grains is probably key in reducing my severe narcolepsy symptoms (I have the research done by a lay-person blogger at zombieinstitute.net to thank for that knowledge.)

    I am on a grief journey (the loss of my 2 year old daughter to leukemia, followed closely by a divorce) and have been healing and processing on an emotional/cognitive level, but am seeing more and more the need to incorporate my whole body in the healing process.

    I was recently introduced to motion as a healing tool – Dance/Motion Therapy – which ties in with the concepts embraced and taught by the people of Movnat.com) And now I am also focusing (thanks to your blog!) on nutrition and re-balancing my whole system as a next step in my journey toward health and wholeness.

    Lastly, I do amateur archaeology in the Eastern Woodlands, and paleo anything is fascinating to me. And viola, the paleo diet might be the way to bridge my current Adderall-dependent lifestyle, with the true wakefullness of a healthy system.

    Keep up the awesome work! And thank you for positively impacting me today.


    • Jack October 21, 2011 at 10:33 pm - Reply

      @Kerri H Thanks for the kind words. Paleo will definitely continue to help you.

  23. Christine October 25, 2011 at 8:03 pm - Reply

    Hi Dr. K. this is totally me, and has been for years. I have improved somewhat, but I still have many of the symptoms. My questions is: I am on my 2nd round of HCG. I have had slow losses, but it is the only thing that has worked to get the weight off. I want to lose 15 more pounds. Am I harming myself if I want to finish off my round (another 3 -4 weeks) and go to the Leptin Reset? The restrictions of HCG have actually helped my leaky gut, I eliminated all fruit and gluten. Or put another way, is it unrealistic to try and lose the last 15 lbs BY THE END OF THE YEAR, with the Leptin Reset if I know I have AF, leaky gut, and high cortisol?

    Thank you so much for all the information you share so generously!

    • Jack October 26, 2011 at 1:09 am - Reply

      @Christine…..you could easily do it……but use the ketogenic version of the paleo diet. this is the autoimmune version as well. Lots of MCT's

  24. christine October 26, 2011 at 2:48 pm - Reply

    thanks Dr. K.

  25. Laurie November 1, 2011 at 2:41 am - Reply

    Hi Dr. Kruse,

    Great blog! I have begun getting labs done to figure out where I fall in the Leptin Resistant continuum. I am 100# overweight, hypothyroid (taking Armour 1.5 grain/daily), and definitely suffering from metabolic syndrome, IR, and who knows what else. I had years of recurring sinus infections, and antibiotics, also sleep apnea, and had surgery last year to correct. One year later, and I haven't had an infection, nor antibiotics, and I sleep well.

    So, I started with the 4x salivary cortisol test, and finally received my results, they were written as follows:

    7:00 am 15.0 (high) normal: 3.7-9.5

    12:00 pm 1.7 normal: 1.2-3.0

    6:00 pm 1.0 normal: 0.6-1.9

    11:00 pm 0.4 normal: .4-1.0

    From this article, my understanding is that cortisol would be low in the morning if I have adrenal fatigue. So, I'm not sure what my results mean, because they are definitely low through the majority of the day. Is it just that I hate getting up at 6:30am so much? Any feedback is appreciated. Thank you!

  26. Jackie November 30, 2011 at 5:50 pm - Reply

    Dr. Kruse,

    Some practitioners limit licorice use to 4-8 weeks. Do you do the same with a somewhat arbitrary cut off or use pt. feedback/labs?

    • Jack November 30, 2011 at 6:59 pm - Reply

      @Jackie……I am a frequent tester so I base most things on labs. I dont like to guess on things.

  27. Mike December 24, 2011 at 7:12 am - Reply

    Dr Kruse: Great stuff, as always…just a point on the melatonin and down-regulation (or lack thereof):

    The amplitude of endogenous melatonin production is not affected by melatonin treatment in humans.

    Matsumoto M, Sack RL, Blood ML, Lewy AJ.

    Department of Psychiatry and Neurology, Asahikawa Medical College, Japan.


    A physiological dose of melatonin (0.5 mg) or placebo was given at bedtime to night shift workers (n = 21) for seven days, and endogenous melatonin profiles were measured on the eighth day. The amplitude of endogenous melatonin secretion was unchanged by treatment. Also, a melatonin treatment trial using a 50 mg daily bedtime dose for 37 days to a blind subject resulted in no change in the endogenous melatonin profile. We conclude that circulating melatonin can shift the phase, but does not alter the amplitude, of pineal melatonin secretion.

    I haven't looked into down regulation of GABA receptors, and that's something I've I've had a fair bit of success with, but long-term use has always been a question.

    • Jack December 24, 2011 at 9:26 am - Reply

      @Mike……thanks for the link and helping improve my former self.

  28. Kristi December 28, 2011 at 7:15 pm - Reply

    Dr. K,

    I'm re-reading several blog posts again, this one included. It's amazing how much more I gain from them each time I read them!

    I have been doing the reset since July, saw all signs, felt amazing and then some pretty large stressors hit our home (loss of our family pet and my husband was laid off work). Add to that I was working hard and late in my own job to make up for lost income and I'm sitting here with what seems like classic adrenal fatigue. The only symptom I don't have is that I go to sleep easily, stay asleep all night and I sleep really well. But, I have a hard time waking up and I always feel as if I need more rest. I have all the other symptoms.

    From a reset protocol standpoint, it seems as if I need to go back to basics and eat 3 meals, being rigid with my meal timing. I'm up with the sun now and although I've not strayed from the protocol much, I typically eat my BAB then don't eat again until around 4-5pm when I eat a small dinner. I'm already VLC since it's winter and I always eat upon waking, although lately I sure haven't wanted to like I used to. So my diet is sound, I just need to get back to beginner meal timing.

    I'm also experiencing what I assume is secondary hypo symptoms. High antibodies, but normal for all other labs. Fix the AF first, then follow with thyroid treatment? I've read it's harder to treat them together.

    Is it possible to tighten up on the reset rules a bit, make sure to get lots of bright light in the am, some salt water with breakfast and begin mindful meditation will help with the AF since I'm already doing all the other things right? I'm unsure as to when the AF would be bad enough for bio-identical hormone treatment? My DHEA is at the low end of normal and my testosterones are at the low (free and total) end as well. Estrogens are right in the middle.

    Thanks for an awesome post, I'm really enjoying reading them all again.

    • Jack December 28, 2011 at 10:26 pm - Reply

      @Kristi your case is a bit more complex and honestlyI think you need to get the hormone issues ironed out while your resetting.

  29. Kristi December 29, 2011 at 9:42 am - Reply

    I was thinking hormones first as well. Complex is right, geez it's nuts! I was feeling awesome, best in many years, and then wham! My cortisol and thyroid went whacky. The more I look, the more my labs point to pregnenolone steal. My labs seem to contradict each other though (from my layman perspective). I'm going to push for another full set of labs (sex steroid hormones–all of them this time!, salivary cortisol, complete metabolic panel and complete thyroid panel with rT3 included–so that I can get an accurate current picture of what's happening. Piece-mealing labs together from different time periods is insane.

  30. Evalinda January 10, 2012 at 11:35 am - Reply

    Dear Doc,

    My friend had Cerebral haemorrhage (in the brain stem) due to ruptured AVM in 2005 at age 28 (male); left hemiparesis, dysarthria, clonus in left calf, diplopia, gross nysthagmus, weight gain in the abdomen and the severe fatigue – he is tired all the time and everything is an effort from the very beginning – the main problem for him. Not especially keen on taking further drugs as he has already had quite a number He is unable to stand because of poor balance, but is able to get himself in and out of bed.

    Is there anything to be done to improve and recover, Leptin RX? Which vitamins are vital?

    He is 33 now, very bright (Oxford graduate) and willing to try everything, but is getting very low and depressed, even suicidal now. Thank you.

    • Jack January 10, 2012 at 1:09 pm - Reply

      @ Evalinda The leptin Rx would likely help his weight but the paralysis actually hurts his weight because of the muscle atrophy that occurs with it. Too bad you are in UK because the Taub clinic in Birmingham, ALA would be the ideal place for him to go. They treat people like him by rewiring his brain with exercises designed to meet his deficits. Tell him to phone them and maybe they can help him.

  31. Evalinda January 10, 2012 at 11:43 am - Reply

    Correction: haemorrhage (in the cerebellum).

  32. Corinne January 21, 2012 at 6:30 pm - Reply

    Hi Dr. K, So grateful to have found your blog, what an amazing resource! A month ago after recovering from viral labrynthitis I noticed my blood sugar didn't feel like it was regulating. I have a history of classic adrenal fatigue symptoms hypoglycemia included. One night I woke up to an adrenaline surge that led to shaking for days. My saliva test showed cortisol in the lower range of normal morning and afternoon and elevated at bedtime. My free t3 is on the bottom range of normal, free t4 the upper range of normal, TSH in the middle, high cortisol in urine, sodium & chloride slightly low, low end potassium, etc. My BP drops when I stand 110/75-96/58. Tachycardia upon sleep, thirst, etc. Seems like classic adrenal glands are tanking to me but no one else has any input. My sed rate was 25 on a 0-20 and CRP was 4.5 on a 0-5. Can adrenal fatigue cause this elevation? Also can adrenal issues cause problems with the ANS, PNS, etc. I was contributing my nerve issues to stress, adrenal probs and chronic gut issues (candida). Any suggestions for where to go for these answers would be greatly appreciated:) Thanks so much!

    • Jack January 22, 2012 at 7:47 pm - Reply

      @Corinne you must get that hs CRP down. WIthout testing its hard to see what is generating the bulk of it. My bet it is your gut.

  33. Dr Cindy January 22, 2012 at 9:14 pm - Reply

    Jack, I am an OB/GYN on day 3 of LRx after 25 lbs off with hCG. I have lots of patients that come in to see me and ask about adrenal fatigue. You know that our training is so poor in this area-where can I find out more therapy for this condition? Do you have a protocol? You mentioned steroids-hyrocortisone-how are you dosing this? How often do you recheck or do you just see if the patient feels better?

    I have a big BHRT practice and see things the way you do-optimize these folks.


    • Jack January 23, 2012 at 9:38 am - Reply

      @Cindy Check this out….. .http://jackkruse.com/what-might-casey-anthony-and-oj-have-in-common/

      I am not a fan of bio identical HC use. SOme use it. I think the real reason adrenal fatigue comes on is because most of these people have a low MSH level which down regulated the POMC protein in the brain. THe most likely etiology is a leaky gut in my experience. It often takes years of good eating and supportive care to reverse. HC is a fast way to help but it carries several big risks. It down regulates the immune system if used past 2 weeks, down regulates the endorphin and endocabinoid system, and it increases division of fat cells that can make weight loss even harder over time. When this happens most people have leptin issues and you need to be extremely LS and have high levels of adiponectin to force adipocyte apoptosis……..there is only one way I know to do stop this……..and it is the focus of the last chapter of my book coming out later this yr………its very difficult to treat if you use HC. So I am leary of it.

  34. Dr Cindy January 23, 2012 at 10:36 am - Reply

    So Jack……

    When folks have adrenal fatigue it boils down to eating right (primal/paleo), optimized hormones, the supportive supplements you mentioned and lifestyle changes (yoga or meditation)-Am I correct? HC isnt something I was gonna jump into with patients.

    Also-do you put epsom salts in your hot tub?

    Dr Cindy

    • Jack January 23, 2012 at 10:44 am - Reply

      @Cindy I do use epsom salts in everything! And you are correct about adrenal fatigue. there are some people who need HC. I have some people with eating disorders I have used it on, PTSD, and Fibromyalgia when I think it is affecting the neurosurgical process I am treating for on them.

  35. Austin January 26, 2012 at 11:02 am - Reply

    When testing for this, do you check DHEA or DHEA-S or does it not matter?

    • Jack January 26, 2012 at 12:18 pm - Reply

      @ austin I check both.

  36. K Claytor February 7, 2012 at 7:26 pm - Reply

    Quote Originally Posted by DrMommyN View Post

    Dr Kruse: Does that apply conversely? If I had no trouble eating a 75 gr BAB right from the gate without satiety, does that imply I cannot "rewire" this way?

    I'm rather stubborn once I set my mind to something (so not giving up), but I've been surprised I haven't done better on the Leptin Reset. That is why I asked on your blog about what happens when my mother had chronic insomnia and stress while pregnant with me. Is there yet another way to rewire?

    Quote Originally Posted by DigitalSurgeon View Post

    you can do it with fat…….but that requires a doctor supervision……so I dont talk about it on the internet.

    Follow you on MDA & saw this about satiety. Have done Leptin Reset per your Protocol since Sept. 2011(clean, no cheating) with the AI Paleo. 80 gm. BAB; still have satiety issues. Please provide the protocol for the fat reset. Please provide me with this specific protocol. I would be so grateful. Thank you so kindly Dr. Kruse.

    • Jack February 7, 2012 at 7:35 pm - Reply

      @K Clayton What part of requires doctor supervision did you not get?

  37. K Claytor February 8, 2012 at 4:58 pm - Reply

    Thanks for reply, will proceed through doctor.

  38. lucy February 18, 2012 at 11:12 pm - Reply

    "In women, I look for (OAT) ovarian, adrenal and thyroid syndrome that have symptoms such as PMS, low body temperature, endometriosis, PCOS, cystic breast, menstrual irregularities, fibroids suggestive of ovarian dysfunction and Estrogen Dominance".

    Dr Kruse, you mentioned quite a few of the problems I am having (which is what lead me to this article) particularly extremely painful menstruation and possible endometriosis.

    So, If I follow your advice in this article for Adrenal Fatigue, might my menses issues clear up as a result? Or, do you recommend a specific protocol for these issues specifically, and if so, can you please link to it? I'm having problems finding any real advice on how to deal with my monthly pain!

    Thanks for any reply.

    • Jack February 19, 2012 at 3:56 am - Reply

      @lucy go read pages 1750-through what the monster thread at MDA are up to now. Pay particular attn to What I say to a poster named glamorama. I also think you need to really read my blog post of 2/11/12. The keys for what you are asking me are all there. http://www.marksdailyapple.com/forum/thread32345….

  39. lucy February 20, 2012 at 8:33 pm - Reply

    Thank you for taking the time to reply, Dr. Kruse, I will have a look at both now.

  40. Loring March 3, 2012 at 9:40 am - Reply

    Hi Dr. K. I'm a latecomer to your blog, so I am in the process of going back and reading all of your posts in order. This post hits the nail on the head for me. And I think my lab work to date supports this. Just wondering after reading your recent material on CT, do your thoughts on CT change any of this post? I think if I remember correctly it seems like we could we use CT instead of adaptogens to recover from adrenal fatigue… I also know that we have to fix the underlying causes – dysbiosis, circadian rhythm mismatch/disturbance, stress.

    Also on #4 – I'm curious if you know if cherry angiomas are a similar etiology as broken capillaries? So far the only answer I have gotten from MDs is "genetics".

    • Jack March 3, 2012 at 3:40 pm - Reply

      @Loring CT is a great for adrenal fatigue Cherry angiomas are from estrogen detox/ concentration issues……that is a sign of a faster chemical clock and a big gut problem or a toxin like BPA or heavy metal

  41. Alisha March 12, 2012 at 5:56 am - Reply

    Hi dr Kruize,

    Amazing work, you’re awsome. Quick question for u. I’m in the midst of treating my adrenal fatique. Insomnia is my main issue. Do u recommend taking a sleeping pill untill my Adrenals recover? Would that speed up my recovery? I figured if I’m not sleeping that wouldnt help ether. Also can u please clarify on carbs I eat mainly paleo can I add buckwheat ? Would that help ?

    Thank you So much. I love reading your work

  42. Jane March 25, 2012 at 5:59 am - Reply

    This is a brilliant summary – wish I had found it earlier. Would you also recommend Ashwaganda as an adaptogen? It has helped me – though I can now see that although I’ve got to many of the things on your list under my own steam and research, I really need a saliva cortisol and DHEA test to go forward – and reconsideration about eating breakfast which I hate!
    Thank you so much for making this information available for free and taking the time to interact with people. I wish you were working in the UK.

    • Jack March 25, 2012 at 8:16 am - Reply

      @jane I do this to help people…….and you are very welcome

  43. vkiernan March 26, 2012 at 6:52 am - Reply

    Dr. K. I need some guidance. You recommended me to do CT and not HC. I am doing baths in 50 degree water 4-5 times a week for 30 min. Just finished my first 4 weeks. I am trying to lengthen my time. If I do the whole body including upper body 30 min. is all I can take; but found I can go longer if I only do up to the rib area.
    1.) Is this enough CT for time and temp?
    2.) Is Isocort an adaptagen or more a form of HC? Is it a good thing or a bad thing for me to take Isocort?
    3.) You also mentioned melatonin, I have read where it’s bad; so it is good to take for AF?

    Thanks so very much for any input you can give me.

    • Jack March 26, 2012 at 7:03 am - Reply

      @VKiernan You have a special issue because of your estrogen issue…..because of that you might need excessive methylation products placed back into your diet while youre doing CT. 30 minutes is not real long but it is still good. For your issue you need longer exposures. So if you cant do it too long I think maybe you consider HC low dose as you continue to CT. As time goes on you should be able to extend your CT time and as you do and recover you can wean your HC slowly

  44. vkiernan March 26, 2012 at 12:42 pm - Reply

    Thank you Dr. K. I will put effort into longer soaks and just bear it as best as I can.

  45. vkiernan March 27, 2012 at 1:00 pm - Reply

    Dr. K,
    I did 45 min of CT last night up to the top of the rib cage so I am working on it. I have noticed that if I do something physical outside the norm like shopping or whatever, I have several really bad days afterwards in terms of being tired and cranky as all get out.
    1.)With adrenal fatigue, how much and what kind of exercise is ok?
    2.)Do I just need to lay low for awhile until things start to kick in?
    Thanks so much for your help.

    • Jack March 27, 2012 at 4:08 pm - Reply

      Vkiernan exercise and AF are not compatible to me.

  46. vkiernan March 27, 2012 at 5:09 pm - Reply

    Thanks. That is what my body is telling me too!

  47. vkiernan March 28, 2012 at 12:17 pm - Reply

    I need to ask 1 more question. You noted melatonin as a good thing for AF, is this true for all that have it? Can I use it since my sleep is not that great to begin with and it’s more wacky since doing CT.

    Thank you very much!

    • Jack March 28, 2012 at 9:46 pm - Reply

      @vkiernan I am not a fan of melatonin for sleep…….just for jet lag. Use ice and dark for sleep

  48. PaleoNana April 11, 2012 at 9:41 am - Reply

    I have AF according to your description in the blog. I’ve had my saliva testing done and my morning cortisol is within optimal range.
    Estradiol 1.57
    Progesterone 30.26
    Ratio of Pg/E2 19.27
    Testosterone 32.92
    DHEA 146.13
    Cortisol Morning 22.51
    I’ve been on the Leptin rx since mid February as well as CT 5x week. Quality sleep is my number one concern. I have not lost more than a few pounds and even that fluctuates up and down slightly. I do feel stronger muscles and have nothing in the way of hormonal symptoms of any sort. I do get an occasional migraine, but usually a CT soak or face soak gets rid of it. Being I have symptoms of AF, do I remain on the rx until that is resolved?

    • Jack April 11, 2012 at 9:52 am - Reply

      @Paleo Nana what are your ref ranges…..and are these blood or salivary tests?

  49. PaleoNana April 11, 2012 at 10:00 am - Reply

    Estrone (E1) pg/ml
    Estradiol (E2) 1.57 pg/ml (1) 1.0-10.8 pre; (2) 1.0-3.2 post; (3) 1.5-10.8 supplementation; (4) <2.5 males
    Estriol (E3) pg/ml
    EQ (E3 / (E1 + E2))
    Progesterone (Pg) 30.26 pg/ml (1) 127-446 pre (luteal); (2) 18-126 post; (3) <94 males; (4) 500-3000 supplementation
    Ratio of Pg/E2 19.27
    (1) 200-600 pre; (2) 200-600 post, supplementation; (3) 200-300 males,
    Testosterone 32.92 pg/ml
    (1) 6.1-49 females; (2) 30.1-142.5 males; (3) 30-60 females, supplementation; (4)
    142.6-350 males, supplementation
    DHEA 146.13 pg/ml (1) 106-300 females; (2) 137-336 males
    Cortisol Morning 22.51 nmol/L (1) 5.1-40.2; optimal range: 18-35*
    Cortisol Noon nmol/L
    Cortisol Evening nmol/L
    Cortisol Night nmol/L

  50. […] gut and adrenal fatigue are two modern diseases that were once evolutionary adaptations that protected us. Both of these […]

  51. Samantha Moodley July 3, 2016 at 4:33 pm - Reply

    Dr K,
    I realise this is an old blog but it’s worth a try..
    I’ve been found to have low cortisol and am waiting to be tested for Addisons Disease. The main reason I instigated a hormone test was because I suffer from Melasma and wanted to get to root of the problem.
    Do you consider hyper skin pigmentation a possible symptom although I saw you haven’t listed it to be one?
    Fantastic info btw, the most informative I have seen so far, thank you.

    • Jack Kruse July 3, 2016 at 8:54 pm - Reply

      Yes I do. Low cortisol and alter melatonin levels go hand and hand. Read my Time 9, 12, and 17 blogs. As of the melasma that one is quite complex: Melasma is a complex skin issue that is due to a mismatch to light. It is tied to non linear optics and free radical changes due to altered spectrum of light on the skin and within the eye. It is a circadian mismatch in the skin which releases excessive light from keratocytes of the skin which in turn stimulate the melanosomes to darken. Decreasing tyrosinase activity is a great prevention strategy for conditions related to the hyperpigmentation of the skin, such as melasma. This specific sensitive environment found in your skin and around their mitochondrial membranes is required for the proper release of UV light from skin cells. It also related to the mitochondrial function skin in another way: One cannot make the free radical signal in a hypoxic or pseudohypoxic state. UV light increases oxygen levels in the skin in the presence of RBC’s When full spectrum sunlight hits out skin blood flow in the skin will rise. In melasma it does not because women are blocking the darkening skin from full spectrum light. This means we need a constant source of O2 and UV light to keep oxygen as our terminal electron acceptor in our mitochondria of the skin. If we don’t use oxygen as the terminal electron acceptor on the skin it favors the growth of bacteria in skin that use other atoms than oxygen. When UV light is also absent simultaneously this increases their ability to grow in a woman’s skin even more. UV light is bactericidal. This causes a large increase in the phenol content of skin because these bacteria are growing. Bacterial growth is linked to UV light exposure. The reason bacterial growth is linked to UV light exposure is because they contain amino acids that photosensitizes them to UV light. In fact,they contain substantial amounts of photo-sensitive amino acids compared to our cells. They have a lot of phenylalanine and tyrosine and those two amino acids are relatively rare in eukaryotic skin cell proteins by design. The reason for the bactericidal effect of UV light upon them is because they absorb greater amounts of UV light from cells that are emitting more of this light. It should now make sense to you why tyrosinase activity and darkening of skin are linked. Tyrosinase is an oxidase (enzyme) that is the rate-limiting enzyme for controlling the production of melanin in our skin melanosomes. So decreasing tyrosinase activity darkens the skin. It is mainly involved in two distinct reactions of melanin synthesis; firstly, the hydroxylation of a mono-phenol and secondly, the conversion of an o-diphenol to the corresponding o-quinone. o-Quinone undergoes several reactions to eventually form melanin. All quinones are also strong UV light absorbers. Here is where it gets complicated because of the non linear optics. Normal sun exposed skin has a lot of RBC’s in it. This is why sunburns are pink. Sunlight increases blood flow by 40-60% to our skin surface. Increase blood flow brings more RBC’s to the skin surface. This delivers more RBC’s loaded with catalase and porphyrins to the surface. RBC’s are also associated with higher oxygen content. RBC’s have an enzyme catalase in them at high concentrations. Catalase is a common enzyme found in nearly all living organisms exposed to oxygen. For example, animals, plants, vegetables, and most fruits have catalase. These things also have phenols in their surfaces. For example grapes have resveratrol in their skin in response to UV light exposure and human skin is supposed to have a lot of phenolic compounds to absorb UV light. Catalase catalyzes the decomposition of hydrogen peroxide (free radical) to water and oxygen normally. It is a very important enzyme in protecting the cell from oxidative damage by reactive oxygen species (ROS). Likewise, catalase has one of the highest turnover numbers of all enzymes; one catalase molecule can convert approximately 5 million molecules of hydrogen peroxide to water and oxygen each second. So it works well when the system is yoked properly to UV light exposure in full spectrum sunlight. UV light increases venous oxygen levels and phenols. This means a lack of UV light exposure cause a pseudohypoxia and a drop in NAD+ in our skin’s mitochondria. This environmental situation alters the amount of ROS and RNS signals in the skin. In women with melasma there is a huge circadian mismatch with respect to UV light. It is usually the frequencies that these women are missing the most because of their location (latitude), the use of sunblock, or the use of glasses/sunglasses/contacts/fake lens replacement. These things all block UV light from the RPE of the eye. The RPE of the eye drives endocrine function in women. This also alters the visual cycle for Vitamin A production in the RPE. Full spectrum sunlight normally increases Vitamin A recycling. Missing UV light decreases Vitamin A in the eye. UV light also increases Vitamin D3 levels in the skin. When the skin is not getting any UV exposure Vitamin D levels also drop. It turns out UV light exposure through your eye clock (SCN) drives your estrogen and progesterone levels via the central retinal pathways (retinal-SCN-hypothalamic-endocrine pathways). When these frequencies (and IR) are missing during daytime hours women usually have very low estrogen levels and anemia. They are also dehydrated as measured via their BUN/creat levels. Those hormone pathways are coupled to a women’s ability to make RBC’s in our blood and make catalase. RBC’s are also loaded with hemoglobin that has porphyrins. All porphyrins also absorb all frequencies of UV light. If there is no proper AM light stimulus of UV and IR light anemia with low catalase levels should be expected. If full spectrum sunlight is not delivered to the eye clock and the skin simultaneously and chronically in the AM hours we should expect the skin on women to darken where this occurs. Why? When I see women with melasma I always ask them about sunglasses and contact lens use. Why? Modern eyeglasses (glass/plastic) and most ophthalmic contact lenses are manufactured to block UVA and UVB light. The same is true for cataract lens replacement. These eye changes lowers the amount of UV light to signal her SCN to lower her ability to generate RBC’s, catalase, and porphyrins in her blood plasma that should increase in her skin with AM light exposure. The skin is loaded with arterioles especially in the malar regions of the face. This is where melasma commonly occurs in females. Women compound the issue because they wear make up on this area of their skin which also blocks UV light in the AM. Melasma is much more common in women who wear a lot of foundation that block UV light on the face. This is why men rarely get melasma. I have seen it in men who wear makeup or use a lot of facial sunblock. A woman who creates this environment chronically on her facial skin will have little catalase present in her skin. Without AM UV light, phenolic skin compounds drop while the RBC mass drops and this alters free radical signaling. Phenols, quinones and porphyrins all absorb UV light. None are present in melasma skin. Therefore the woman’s skin released more ELF-UV because it is pseudohypoxic. The excess release of light drives melanosomes growth and the skin darkens because RBC’s catalase, phenols, quinones, and porphyrins are missing. This alters your skin thickness while making it more sensitive to any light. Artificial light is not full spectrum sun light and is also missing UV light. This makes the situation worse. Most women with melasma work indoors out of the sun. When your skin is low in catalase, porphyrins, and sees constant levels of artificial light frequencies, you begin to make a lot of ROS, like hydrogen peroxide. When H2O2 is made in large volumes you need to clear it fast using catalase in RBC’s that are not there! Your skin darkens. In women with melasma catalase is not there. H2O2 build up normally and interacts with the phenols in your skin and releases light as a photochemical response. The phenols, quinones, and porphyrins are the proteins that normally absorb these UV light frequencies so the melanosomes never get stimulated to tan. If you don’t believe this is how the reaction occurs google a light glow stick. This photochemical reaction is exactly how a child’s glow stick works at night when you activate it by squeezing the three chemicals together. It uses 3 chemicals to make light. H2O2, a phenol derivative are kept separate and when you break the light stick they mix. The 3rd chemical is a fluorescent dye added in for you to see the the light made when H2O2 and the phenols mix!!!! In a woman with melasma, her melanosomes see the light frequencies and not the porphyrins, phenols, and quinones. Melanosomes are optimized to sense “blue light” frequencies most. UV light is in this part of the spectrum and the skin darkens. The inability to clear the ELF-UV light release from a woman’s keratinocytes is what darkens her skin. Dermatologists are powerless in treating this condition because they do not understand the quantum mechanism. They tell the public that UV light is toxic for the skin or your eye!!!! In reality, a lack of UV light causes this condition. It is also why women who take birth control pills get more melasma. Taking exogenous estrogen while having a serious deficiency of UV light on the skin and eye will lower the endogenous production of estrogen further, and this act’s to lower a woman’s, hematocrit and hemoglobin. Often these women will report dramatic menstrual irregularities. Dermatologist rarely ask about this. They rarely ask about eyeglasses, sun glasses, or contact use. The irony is that when women complain the OB/GYN about the menstrual issues that accompany the endocrine loss of estrogen, what do they do for these women? They prescribe exogenous birth control pills to normalize their cycle. This stops the abnormal bleeding and pains, but makes the skin melasma worse. This is why dermatologist think estrogen and sun light is bad for melasma!!!! If it wasn’t so sad it would be funny. This is why melasma is the hardest thing they see in their practices. The quantum truth tells us why they believe it. It turns our exposing the skin and eye to normal full spectrum light is quite helpful. I talk about this process in Ubiquitination 23 on my website. REVIEW: If you cannot clear H2O2 fast enough (catalase job) there will be excess light release from the skin cells (Ketinocytes) to darken the skin in this area. This reaction will liberate light normally. The light liberated by this interaction causes stimulation of the melanosomes in your skin and they darken. Melanosomes are relatively large organelles, measuring up to 500 nm in diameter. Melanasomes are dependent for their pigment on a set of enzymes within the cell (especially tyrosinase) that synthesise the large polymers of melanin. This is why blocking tyrosinase is being carefully studied now. Very complex optics I described here; but the smart move is to get full spectrum AM sunlight on your face and skin. Do not wear make up or glasses until you reverse it. Glass blocks UV. The other thing to do is increase the amount of flavinols in your diet. Curcumin and resveratrol are the ones I talk about a lot. Things with Vitamin K 2 work too. They all have quinone rings in them that also absorb all forms of UV light. I had a friend who I gave this information to and she created an elaborate bio hack using a lot of optical ideas. Her results were quite good without a lot of medicine. She was spending 300 dollars a month on glutathione injections into her skin with the dermatologist for 5 years to control her skin darkening. It never went away and she got really bad splotchy spots doing this. She had this condition since puberty and she made some Epi-paleo Rx dietary changes (DHA with flavinols) and used black lights at her home and office and her melasma went away in 12 months and psoriasis and arthritis went into remission.

  52. Keith November 15, 2016 at 4:39 pm - Reply

    Can adrenal fatigue start out with earfullness and tinnitus? I’ve been paleo for over 2 years and was feeling great. About 8 weeks ago I started experiencing these ear issues. The ringing is 100% of the time…the fullness comes and goes. Since then my HRV has been trending down steadily (rmssd), and hf and lf trending down as well. ENT says everything is fine. Could adrenal fatigue be causing this, or could the constant stress I’m under from the ringing be what’s tanking my HRV. I’m not sure where to start to seek help at this point. Any thoughts?

    • Jack Kruse November 16, 2016 at 9:48 pm - Reply

      Keith it is possible.In biology, the lower energy systems required for autonomic or vegetative functions. The brainstem get energy loaded first, at the expense of the more energy intensive systems, like the brain’s neocortex. If no energy is remaining after the basic systems are loaded with energy, the brain runs at an energy deficit, and it directly affects neocortical function. Moreover, the brain is built by evolution to “steal energy” naturally to preserve its own function in mammals, because it has the physiologic ability to auto-regulate its oxygen and blood flow requirements itself. This makes the brain quite unusual in this sense.

      This means that the brain will preserve its function at the expense of other systems. This helps you understand where tinnitus and hypertension really come from. As energy is lost from our body systems back to the environment for any reason at all, the brain increases its mean arterial pressure to maintain its energy status at the expense of other systems. This is why BP rises in non-wellness states. When this happens in the brain, cognition suffers in the regions of the brain that are most energy dense. The next system in line is the immune system. It was the system that the primate tree innovated before neurogenesis occurred using the changes in the MHC1 gene.

      In the archeo-cortex hearing sense is an energy hog. This is why tinnitus is a big clue to a clinician that a patient’s environment is sub-optimal. Ammon’s horn, part of the hippocampus, is the most energy-inefficient part of the neocortex. It is one of the first areas affected in Alzheimer’s disease. This is why, in anoxia or pseudohypoxic states, we see this area of the cortex affected first. The areas most affected earlier by lowered blood flow are the parts of the cortex that cost us the most energy. This is how why tinnitus is a symptom showing us we are deficient in photon assimilation or electrons in our tissues.

      Charge in the human body is built by the assimilation of UV photons that are being recycled through nucleons, atoms, and molecules. Light is carried by photons, and photons have both energy and momentum that travel in ambient electric and magnetic fields that we measure or sense in a variety of ways. Light gives a charge to our proteins and lipids below our perceptions. Sunlight recharges the batteries in us that make life possible. Charge is normally composed of smaller photons that have had their energy and momentum harvested by our tissues. Light devoid of energy and momentum is heat. Heat is red light. Red light augments ATP creation, and red light carries the least amount of power in all of light’s colors. Ponder that for a minute. People focus in on red light as a “healing frequency because they fundamentally have no idea of how light really works in tissues to regenerate us. Nothing is more regenerating to us than UV light. It contains the most charge because it has the most energy and momentum to change us and our lives. Charge can also be thought of the same as heat because heat is also a form of light used within mitochondria for signaling. Heat is caused by the motion of photons stirring within us looking to still have a usefulness to our bodies. We are built not to waste any light. When we waste it in our auditory relays tinnitus is the result.

      • Jack Kruse November 16, 2016 at 10:14 pm - Reply

        Tinnitus is the brain trying to heal itself but it cannot. Tinnitus arises when this flexibility goes bad inside of the mitochondria. It’s mitochondria in Ammon’s horn looking for the right frequency so mitochondria can increase tunneling speeds and become better able to use beta oxidation for fats and the TCA cycle for glucose. The key to understanding neuronal function is understanding how a reflex organizes the entire nervous system. This goes back to the work of Sherrington in the 19th century. Bereft of incoming signals, the neurons lose the feedback control and they begin to do things they usually would not. This is what gives the phantom sounds of tinnitus. Neurons tuned to the tinnitus frequency in the auditory cortex became less active, thus this alters the reflex arc between the cochlea and the auditory cortex and brainstem. In all of these places, their is wide spread energy deficits in mitochondria that reduce the activity of neurons. Calcium efflux is usually behind this secondary effect of lower energy out put of tissues. It turns out out of the 5 senses hearing using the most energy because of its ability to distinguish waveforms is so sensitive. For example all humans can tell the difference between a sound that is 30 Hz or 60 Hz. The same is not true about our eyes and vision. Few people can sense the difference between a pulsing light at 30 cycles a second versus 60 cycles a second.

        • Keith Duco November 19, 2016 at 1:22 pm - Reply

          Wow. That’s a lot to read an comprehend! Thanks so much for the response. Im fathering from your response that I may be lacking in UV light exposure? Please correct me if I’m wrong. I haven’t bee outdoors as much the last few months so that makes sense to me.

          • Jack Kruse November 19, 2016 at 3:47 pm

            Keith this reply will be no surprise to my members but it may be new information to you. Tinnitus is linked to a lack a solar light for deep reasons tied to leptin resistance and defects that occur at cytochrome one in acoustic systems neurons. Vitamin B12 and Vitamin D 3 are vitamins linked to proper solar exposure. If you lack sunlight, for any reason, leptin resistance develops in specific locations in the body and diseases begin to manifest that ruin the NAD+/NADH redox couple at cytochrome 1. Obesity and T2D are diseases of darkness due to a lack of sunlight. Tinnitus is a bit different but the mechanism is similiar because it is linked to spectral densities of light. Obesity and T2D are effectively spectral solar deficiency diseases. A lack of solar light during the day is one side of T2D and obesity, but the presence of blue light at night effects another pathway that the human eye uses at night to optimize the mitochondrial in melanopsin, RPE, and the central retinal pathways that control the eye clock mechanism that controls circadian cycles. The absence of blue light at night is critical light effect needed to catalyze the solid state conversion of serotonin by using the process of methylation. Methylation during darkness mediates circadian clock plasticity both in the SCN and in the peripheral clocks. This solid state biochemical process requires a large exclusion zone (EZ) and the presence of vitamin B12 and folate. B12 is made in the liver under the presence of SOLAR daylight. Folate, on the other hand, is destroyed by full spectrum sunlight and it is produced under darkness when blue light is ABSENT. These are the two chemical arms that tell the quantum clinician if a patient is solar deficient and/or blue light toxic. Obesity and T2D are two such quantum diseases that manifest when this situation occurs in humans. B12 and Vitamin D3 are linked to specific sunlight frequencies and this is why pernicious anemia is associated with a lack of sun. In fact, most anemias are related to a lack of proper solar exposure. This link to anemia and B12 was found by Fritz Hollowich in the 1940’s. In fact, I have found a link to low solar exposure and low B12 that dates back to 1927. It seems these links are well published on a long time ago but seem to be unknown by modern humans. It is nice to see medscape making the connections. T2D and obesity are epigenetic diseases of light that ruin cytochrome 1 and the Q-cycle. http://www.medscape.com/viewarticle/872008

  53. Keith November 19, 2016 at 7:21 pm - Reply

    Thanks again. Yes, a lot of this is new to me and way over my head but I have to start to learn sometime. I’m starting to read as much of your information that I can. Even though I’ve been paleo for about 2 years, I’m going to start the Leptin Rx. I usually eat mostly fat in the morning…little protein. I’m not overweight but could still possibly be leptin resistant. I’ve never been big on supplements, and at this point I’m not really sure if or what would be needed. Thanks so much again. I’m sure you will hear more from me in the near future.

  54. Djones December 4, 2016 at 8:48 pm - Reply

    Hi, I understand this blog was posted a long time ago. I recently had salivary hormone levels tested. I have higher than reference range for DHEA, but lower than reference range for cortisol (mostly a flat line curve), estrogen and progestrone. I worked night shift for over 5 years (i now work evenings and get home by about 130am). I am severely exhausted all day. I have actually lost 40lbs without trying and continue to loose a pound or two everyday now ( I am 5’3″ and now weigh under 110) and I have developed gut issues that it seems does not allow absorption of any nutrition. I feel like my food is no longer supplying me with any energy to be productive during the day. My diet is decent – no refined carbs, mostly vegetables and whole grains based with rare chicken. I also do not have hypoglycemia – if anything my sugar levels have been on the high side. My Hgb A1c has been as high as 6.0 and with the weight loss it has come down to 5.6. Now my sugar levels are under 100. I sometimes sleep well at night but most days i wake up a couple times during the night unable to fall back to sleep right away. What are your recommendations in order to start solving the issues? My naturopathic doctor has me eating Vit C and lots of B5 as well as B complex as well as a supplement called TAD+ which is a combination of lots of minerals and bovine adrenal and spleen concentrate. It boosts my energy a bit but it is not a permanent solution by any means. Looking forward to hearing your response. Thank you!

  55. Kirsty December 27, 2016 at 5:33 pm - Reply

    Hi there,
    Just found this sit a few days ago. Can relate the this post and IR. looong history of fatigue. After several years of high cortisol (esp at night), I’m now low all day. Low BP, dizziness, eat to feel energised (with limited results), heart palpitations and all the classic signs.
    Wondering which protocol to look at. And would the ct one be worthwhile also. Currently using high dose progesterone , and will eventually reduce back to a maintenance dose. Compounding pharmacist recommended t3 which I took for 4-5 weeks. I’ve stopped now as heart rate was getting high. Can’t say I feel much better after taking it. Was energised and getting more done whilst taking it, but maybe at expense of adrenals ? As I’m back in bed a lot.
    A bit tired to read all the great content on here, so wondering if you could point me in the right direction. Is it all in a book? Or within these web pages. Ta. Oh, I’m nearly 42, and female

  56. steve May 10, 2017 at 11:23 am - Reply

    “avoid starches” and “avoid high glycemic fruits”. So that means Kruse believes a low carb diet is required.

    There are no moderate or high sources of carbs that are not starches and not sweet. So stating “a low carb diet” would be clearer.

    • Jack Kruse May 12, 2017 at 3:13 pm - Reply

      Kruse doesn’t say that at all. It is a seasonal apporach tied to the photosynthetic yield of your local region. The amount of nnEMF and retinal damage you have determines the amount of DHA needed.

  57. Suzy Mccoppin July 5, 2017 at 10:57 pm - Reply

    SO DESPERATE FOR HELP! This is the first site Ive read in 7 years that seems to understand my problem. I’ve been on prozac for 20 years, and ever since titrating down 10 mgs a month 7 years ago, my hypoglycemia has been UNBEARABLE!! Yet, my blood sugars are normal. I have to eat almost constantly, sometimes force feeding myself 2 lbs a meat a day. I’ve even eaten out of trash cans out of desperation and sometimes I can’t leave the house because I need to be around food. To be clear, I derive NO PLEASURE WHATSOEVER from eating. I also have mercury poisoning and parasites, but I’m so exquisitely chemically sensitive, I can’t even have a sip of decaffe let alone a supplement. Can someone please help?? I’m so desperate. I can;t live like this anymore.

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