My ongoing battle with adrenal fatigue began to manifest even before I experienced the obvious onset of Hashimoto's/Hypothyroidism in early 2003. I began to notice months previous to diagnosis, that my tolerance for stress and my recuperative abilities, to spring back from hard physical activity, illnesses, excessive stressors etc.., was slowly diminishing. When my hypothyroid disease kicked in, the adrenal fatigue hit a peak of severity and the combination of the two really threw me for a loop.

The first Doctors I went to didn't investigate to find the thyroid disease and I was not being treated for it, so in the mean time I had to push myself incredibly hard just to keep going because I also had an extremely stressful job situation, managing property at that time.

Finally at one point, the adrenal fatigue turned into severe "adrenal exhaustion" and I experienced a strange viral type illness that left me with severe hives (these resolved) and swollen neck lymph-nodes that are swollen to this day! This is also when my chemical sensitivities became much worse to caffeine chocolate, alcohol and stimulants of any kind. In other words I had developed increased multiple chemical sensitivities (MCS).

I finally demanded blood tests and as a result, was treated for diagnosed hypothyroidism but the adrenal fatigue remained, re-occurring in flares of symptoms. Over time, I learned the difference between the symptoms of adrenal fatigue/exhaustion and thyroid symptoms. With adrenal exhaustion, I get severe post-exertion malaise and it can take a couple of days sometimes to recuperate from hard physical activity.

I have since been treated for these health disorders and have seen significant improvement in them. I do still experience flares in symptoms, if I venture outside of a diet restricting stimulants or if I do not keep my stress levels under control.

It is my belief that CFS is a type of adrenal exhaustion and that adrenal fatigue can be a forerunner to it in some cases. The most well-established feature of CFS that you find in medical research (also fibromyalgia), are "low cortisol levels" and I do not believe this is a coincidence but something that makes sense because the main purposes of cortisol is regulating stress and controlling inflammatory responses in the body. Two of the doctors I have been treated by since 2003, also diagnosed me with co-morbid CFS.

The adrenals when low functioning, cause more allergy, viral and illness responses to occur, due to the adrenals role in immune system function, being greatly diminished. Cortisol is also our body's natural anti-inflammatory and so low levels give rise to joint & muscle pain and other inflammatory reactions in the body. All of these factors combined, contribute to the symptoms of adrenal fatigue and CFS and can add to the symptom struggles of hypothyroid patients who have these co-morbid conditions.

Many Doctors only recognize the most severe form of adrenal hypo-function called Addison's Disease or full blown adrenal insufficiency and they base whether or not a patient has this life-threatening form, via the "ACTH Stimulation Test". The problem is that many people have a less severe form called adrenal fatigue or adrenal exhaustion and

though these patients nearly always pass the ACTH Stimulation Test, they still have inadequate adrenal hormone levels that show up clearly on lab tests and though it is not life-threatening, it still causes symptoms that can seriously affect quality of life.

Even the National Institutes of Health, while studying Chronic Fatigue Syndrome, found "low cortisol" to be a factor in it as well and in the study, they made this statement; "Doctors have long known that even subtle deficiencies in cortisol can be associated with lethargy and fatigue." (LINK>> www.nih.gov/news/pr/oct96/niaid-13.htm )

The "NIAMS" (arthritis etc...) Division of the National Institutes of Health also recognizes low cortisol in Fibromyalgia. Other studies they've published on the PubMed/National Libraries of Medicine website, also recognize low cortisol in PTSD (Post Traumatic Stress Disorders).

The fact is, adrenal fatigue can be a factor in these and other chronic diseases/syndromes or not be related to anything specific.

One major virus that other NIH studies have concluded as being highly associated with CFS, which also has low cortisol as a feature, is the Epstein-Barr Virus. I had a severe case of mononucleosis as a kid, about age-10 and have always believed there is a connection of it, to both my thyroid disease and CFS.

When I was optimized on thyroid hormone replacement for hypothyroidism but continued to have symptoms, some that were not typical of thyroid (severe post exertion malaise, swollen neck lymph nodes, orthostatic hypotension), I decided to get tested for EBV, just out of curiosity because I had read so much about research that suggests the possibility that EBV like others in the herpes virus family, can flare-up in persons with a compromised immune deficiency (immune dysfunction).

My EBV/IGG result was "218" with the normal range being <20 (less than twenty). This means my EBV count is more than 10 times the normal cut-off range. While a large percent of the population tests positive for EBV (statistics estimate 80%), titers as high as mine are not common, unless a person is actually experiencing active-mono.

For me, the EBV I feel has a connection to both Hashimoto's Thyroiditis (there is also NIH research on this) and CFS.

The most important thing, if you feel you may have adrenal fatigue, is to be tested for it because other hormone imbalances and illnesses cause similar symptoms.

More pharmacies are now carrying "ZRT Labs" saliva hormone kits, including the ones that test adrenal hormones, so you can check around for these.

The passion I have in the area of adrenal fatigue, besides having it myself, as part of CFS, is the fact that far too many studies and reputable organizations recognize it, including the "Fibro & Fatigue Centers", in 15 states, that are staffed by Board Certified MDs from just about every field of medicine, for people to still believe it is just a pseudo-syndrome. This plus the fact that there are U.S. Government health studies also concluding that there are low-cortical syndromes, well establishes sub-clinical forms of adrenal hypo-function, that could all be referred to under the term; "adrenal fatigue".