I want to share with you everything I know today about the 4 stages of adrenal fatigue.

My Story

Oh do I have a story for you today. One that might shock you a little. But it’s important to me that I share this story so that when I explain the 4 stages of adrenal fatigue it all makes more sense, AND you will have the context to maybe dig into this for your own life.

In 2014, I shared a post on this website called, “I Have SIBO.”

If you’ve been an avid A Gutsy Girl reader, then you might recall it.

The sum of that (otherwise short) post was to share that I was finally diagnosed (via medical testing) with all the things that had been keeping me sick for so long: 

  • SIBO
  • severe adrenal fatigue
  • a low functioning thyroid
  • Vitamin D deficiency
  • Vitamin B12 deficiency

And at the time, of all the things I was diagnosed with, the one that disrupted my life the most was SIBO.

So, for the next 4 years (until 2018 when I healed SIBO for good), I focused primarily (only?) on SIBO. 

People always ask, 

If I’ve been diagnosed with multiple things, which one do I focus on first?

My response, due to my own personal experiences was always,

Focus on the one that is causing you the most pain and agony in your life.

I still stand by this because I believe that healing multiple things at one time is similar to the snowball effect; when one gets better, the others start getting better, too.

Anyways, I honed in hard on the digestive issues.


…..But What About the Rest?

Well, my thyroid function also improved. And we already know that there is a correlation between the thyroid and SIBO. 

One of the best things I did for my thyroid was to go on WP Thyroid, which is a natural product made from animal thyroid glands and is used to treat hypothyroidism (low thyroid).

Along the way (since 2014), I kept up on getting thyroid levels tested to ensure that it was still being kept in check.

The most recent thyroid test was completed in December of 2023, and by this point everything except one marker is within normal range. And that one thing, my doctor didn’t see an issue with.

​So, then, what’s the problem?

Adrenal Glands

The most recent Adrenal Hormone test I had done (results came back in January, 2024), found severe adrenal dysfunction.

If you want my very transparent truth, you’ll find my testing results BELOW.

The reason I am putting them there vs. here is because I want to take you through the following first:

  1. What are the adrenal glands?
  2. The 4 Stages of Adrenal Fatigue
  3. ….and what are the symptoms of adrenal fatigue

Then, I’m sharing my own results PLUS what moving forward looks like (for me).

What are the Adrenal Glands?

Before I share the 4 stages of adrenal fatigue, I want to explain what the adrenal glands are because I think there is a lot of confusion and misinformation out there.

First, throughout this article I am likely say “Adrenal Fatigue” BUT if you go to your primary physician and say, “I think I have adrenal fatigue; could you please test me?” They are likely to roll their eyes at you – either directly and outwardly to you or silently to themselves.

This is because it’s not the technical or medical term.

The true term is: HPA-Axis Dysfunction.

Restoration Healthcare states it as such,

HPA axis dysfunction is a more accurate diagnosis than adrenal fatigue because it recognizes that the adrenal gland does not operate in a vacuum; problems upstream of the adrenal gland can and often do impact adrenal function. “HPA” refers to the three components involved in adrenal hormone production.

These three components include:

  1. Hypothalamus
  2. Pituitary Gland
  3. Adrenal Glands

All three work together.

But, specifically, the adrenal glands:

….release certain hormones directly into the bloodstream. Many of these hormones have to do with how the body responds to stress, and some are vital to existence. Both parts of the adrenal glands — the adrenal cortex and the adrenal medulla — perform distinct and separate functions.

Here is a simple image from Wikimedia Commons that shows exactly where the adrenal glands are in the body:

Adrenal Gland image via Wikimedia commons

Significance of the Adrenal Glands

Besides the more medical definition of the adrenal glands, here are some common terms to help you understand what they do and why they are so important:

  1. Adrenal glands are part of the endocrine system.
  2. They produce hormones that help regulate your metabolism, immune system, blood pressure, response to stress and other essential functions.
  3. ….and when they do not produce enough hormones it can lead to adrenal insufficiency (Addison’s disease).
  4. The adrenal glands work to produce cortisol.
  5. Other parts of the body the adrenal glands work with: hypothalamus, pituitary gland, kidneys, sympathetic nervous system

The adrenal glands are imperative to overall health.

So, then, what are the health problems that can occur when the adrenal glands are not functioning as they should?

While there are many (everything from Addison’s disease to Cushing’s syndrome), the focus of this article is to share about adrenal fatigue. 

The 4 Stages of Adrenal Fatigue

Click HERE to save this article on the 4 states of adrenal fatigue for later.

The 4 Stages of Adrenal Fatigue agutsygirl.com

Let me describe for you, in Layman’s terms, the 4 stages of adrenal fatigue, along with their symptoms and relevance on your life. 

Stage 1

In Stage 1, the early stage, your body is in a basic alarm reaction. And if this is where you’re currently at, it’s good news because you’re early on in the journey and by making changes now you can prevent more damage from being done.

NOTE: I WISH almost more than anything that I would have seen a functional practitioner in my 20’s when I started having these symptoms. Because, quite honestly, I believe from the depths of my soul that I could have squashed it all then AND would not have gone through “unexplained infertility.” I’m 99% sure that THIS was the cause to the infertility.

During the first stage of adrenal fatigue, you might not notice anything, except for some minor fatigue. You may start having low energy, but again, it might not even be noticeable. 

I mean, doesn’t everyone experience some sort of fatigue that they chalk up to “I’m just doing too much?”

Stage 2

In the second stage of adrenal fatigue, the body is started to become more resistant. It might start giving the signals that you need to slow down.

The adrenal glands in this stage are now beginning to not​ produce enough stress hormones to meet the increasing demands that are being put on the body. 

Because your stress hormones are producing less, you may experience things like:

  • More, and general, fatigue and tiredness. These can start to creep into your everyday life.
  • You may experience more sickness and/or find that when you do get sick it takes longer to recover. 
  • If you find yourself prone to things like anxiety, irritability, mood swings, and insomnia, this could gradually get worse.

Stage 3

Well now you’ve hit the 3rd stage of adrenal fatigue.

By this point I’d gather you are really starting to realize something is not right (if you don’t already) because you are experiencing adrenal exhaustion. 

Something very important to make note of here is that your cortisol levels have now dropped! One thing that we always hear about with too much stress is, “Cortisol is too high.” And this is true. In the beginning, our Cortisol levels are too high and is oftentimes compared to “being chased by a lion.”

The NIH states, “In our study, cortisol levels in stressed period were found to increase about 9 times compared with relaxed periods.”

HOWEVER, and this is also very important, once we have been chronically stressed, cortisol actually decreases. This is known as the Negative Feedback Loop. And, according to the University of New Hampshire:

People who experience chronic stress, however, become more resistant to the signals that tell the body to “chill out” (the negative feedback loop). Because of this, the body will continue to release CRH and ACTH which leads to the adrenal glands over-producing stress hormones.

If a stressor is long-lasting or intense, the body’s resources can become depleted, leading to exhaustion or “burnout.” When the body is chronically stressed, the increased production of stress hormones compromises the immune system and can lead to significant mental and physical health problems.

The body is trying to compensate, it’s desiring to get back to a level of homeostasis so cortisol drops.

Another way to look at it is this:

“High cortisol happens when the body perceives a stressor,” says Dr. Tara Scott, a functional medicine doctor. “Your brain doesn’t know if you are running from a bear or have a deadline at work.”

“Low cortisol occurs after prolonged stress, when your body sends a negative feedback signal to the brain saying, ‘We have plenty of cortisol down here, don’t stimulate more production!'” Scott says. 


(ALSO, see the Four Faces of Adrenal Burnout HERE. Notice how after stage 2, cortisol then drops.) 

So, here are physical symptoms you might experience in this stage:

  1. Highs and lows throughout your days
  2. Extreme tiredness at the end of each day (and even throughout your days)
  3. Inability to ever feel “refreshed”
  4. You may experience digestive problems that cause everything to “slow down”
  5. Libido is impacted and you experience a low sex drive

Stage 4

And last, but certainly not least or to disregard, would be the 4th and final stage.

You have arrived at total burnout.

When you’re in adrenal burnout, you’ll experience things like:

  1. The nervous system and reproductive systems completely impacted.
  2. Body aches and pains
  3. Low blood pressure
  4. Skin issues
  5. More digestive problems
  6. Cold intolerance
  7. Dehydration

Adrenal Fatigue Stages: Where am I?

Well, let’s let my lab results show you.

A Gutsy Girl adrenal fatigue stage 3 results agutsygirl.com

After understanding the above and looking through the different stages of adrenal fatigue, I’m somewhere between state 3 and 4 (according to my functional practitioner).

(Note: I did my saliva test through Labrix; Doctor’s Data and on this graph, the stages end at 3 vs. 4.) 

I think Dr. Hagmeyer has an excellent graphic to demonstrate where I’m at compared to….

Dr. Hagmeyer Stages of Adrenal Exhaustion image

To be clear:

I do NOT have all the Stage 3 and/or 4 symptoms.

For example, and maybe namely: I have ZERO digestive issues. I am 100% bloat-free and remain a 3/4 on the Bristol Stool Chart every single day.

I thank GOD and my ultimate devotion to the gut for that.

In fact, THIS was one of my TOP questions for my doctor —

If it’s so bad, then how come I do not have any digestive issues?

The answer, like everything else, is that a list of symptoms aren’t universal. You might have only 1 or 2 symptoms from any given list. And yet, that doesn’t mean the underlying problem is or isn’t there.

THIS IS ALSO WHY when I research and provide information about various digestive conditions I give a comprehensive list of symptoms. Because you might have 1 or 2 of them OR you might have them all. When I had SIBO, I had allllll the symptoms. Not so much here.

However, also to be clear: I do, in fact, have a TON of extreme stress in my life. 

And there is absolutely, positively, 1,000% no way to sugar coat this.

For the purposes of this article, it is not my intention to go into the depths and details of my life. 

But I cannot, for one second, try to tell you “I have no idea why I have arrived in this place with adrenal fatigue.”

I get it. The writing has been on the wall.

And here’s the thing. Go back to the beginning of this article. I already had severe adrenal fatigue back in 2014. But it was not my priority then. I sought out proper treatment and 100% intense focus on healing SIBO.

I achieved that. 

But sometime during 2023, these intense adrenal fatigue symptoms resurfaced. “So,” I thought, “I should dive head first back into the exploration of adrenal fatigue.”

So I took the initiative – spending time, money, and energy – to arrive here today.

THIS is what I’m constantly promoting and encouraging for you, too. SPEND the time, money, and energy NOW so that it saves you (even more) time, money, and energy later.

Adrenal Fatigue Treatment

What’s next? What now? And what’s the first step in healing?

The good news is that I already know. I know what to do, and I teach these lifestyle changes and factors in GUT HEALING: ELEVATED.

From my functional medicine practitioner’s perspective, the healing process consists of:

  1. Nutritional Supplements (by the way, there are 4 supplements trackers I can use in Ahara Dinacharya to track these supplements daily):
  2. Diet and nutrition: adrenal-supporting foods (I am sharing this specific list in Gut Healing: ELEVATED because remember, I whole-heartedly believe that we only get results when we invest in ourselves via time, money, and/or energy.)
    1. Fiber intake increased
    2. Meal frequency; eating 4-5 vs 3-4 times per day
  3. Lifestyle
    1. No alcohol – I was already doing Dry January, and I think I’ll just keep going
    2. No caffeine – I have gotten myself down to just 1/4 – 1/2 cup per day, so I’ll completely quit soon
    3. More sleep – yes, even more but now I’ll pay attention to my Oura ring with extra detail to ensure it’s not poor sleep quality
    4. Ordered THIS lightbox – starting with 20 minutes per day in the morning
    5. Light exercise – never to exhaustion, and honestly – I rarely do exercise to exhaustion anymore because I’ve believed for many years now that intense workouts and healing cannot co-exist
    6. Stress management – I’ve been practicing many of the top ways for stress management, but clearly I need to adopt more or make some sort of other change
  4. Adrenal Renew
  5. Licorice Complex
  6. DHEA (btw – yes, my DHEA levels are tanked, too)

Note: In THIS article, they state:

We discussed general causes of cortisol imbalance above, but dig deeper. Go past “diet” or “exercise” and ask yourself if your hormone levels are wacky because of: 

  • Your job 
  • Relationship stress (significant other or family)
  • Hustle culture/doing too much
  • Lack of sleep 
  • Too much of one type of exercise (probably HIIT) 
  • Alcohol or caffeine consumption
  • Lack of mindfulness or stress-management practices

And in Gut Healing: ELEVATED we cover them all.

I will retest in 3-6 months and if I am not improving then I’ll need hydrocortisone tablets, which work by replacing the hormone and bringing your levels up to normal. We would love to avoid this if at all possible, but I’m also not willing to let this medical condition get worse.

Just Like Healing the Gut

One thing I’m certain of is….

Action creates consistency.

Consistency creates results.

Results create growth.

This was my EXACT blueprint for healing my gut.

And I know I can replicate that blueprint to normalize the stress response. 

I realize this has all been a long time coming. 

My lab tests are simply just now proving it.

Always take care of YOU, always.

If you liked this article on the 4 stages of adrenal fatigue, you might also enjoy:

  1. Destroyed Hormones
  2. 5 Best Natural Remedies for Fatigue and How to Test For It
  3. Adrenal Fatigue Test


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