The 4 Stages of Adrenal Fatigue & Common Symptoms

Adrenal fatigue has unfortunately become synonymous with modern life, as Dr. Michael Lam says. Most of us live in a way that is so far from how we are supposed to live naturally. The daily stressors, physical, mental, emotional, and environmental, are too much for our bodies to cope with. We have the same stress response that our ancestors would have just by being near a blood-hungry tiger, by checking our emails. This is happening multiple times throughout the day, and our stress system can’t handle it. That’s why Adrenal Fatigue Syndrome is one of the most common (yet also dismissed) conditions of our time. 

In this article, we’re outlining the four stages of adrenal fatigue so you can get a better idea of where you stand and where you need to begin to heal. 

The Four Stages of Adrenal Fatigue 

First things first: adrenal fatigue is way more common in women than it is in men. This is because not only are we often forced to be the caretaker, the worker, and everything in between—but our hormones are constantly in flux, while men’s stay relatively stable throughout their lives.

It’s not typical to not have adrenal fatigue one day and then immediately have it the next day. There are adrenal fatigue stages, and it’s important to understand these so that you don’t enter into a worse stage.

What are the symptoms of Adrenal fatigue? 

Your adrenal glands are what produce your body’s main stress hormones. When you are constantly stressed, overworked, and burnt out, they increase their output until they can no longer do so. 

Common symptoms of adrenal fatigue include sluggishness, weight gain, insomnia, mild depression, inability to handle stress, lowered immunity, poor sex drive, PMS, lightheadedness, anxiety, sugar and salt cravings, and more. Symptoms will vary in type and intensity depending on what stage you are in. 

What contributes to Adrenal Fatigue?

There are different stressors that can cause and worsen the progression of adrenal fatigue, including:

• Psychological stress and lack of management 
• Eating unhealthy diet and processed foods
• Overconsumption of sugar, alcohol, and caffeine 
• Exposure to toxins
• Chemical-laden products (endocrine disruptors)
• Regular use of certain medications like antibiotics 
• Poor gut health
• Chronic illness 

The root of adrenal fatigue is HPA axis dysregulation, which happens when these stressors are at play for a consistent period. Here is the outcome:

The 4 Stages of Adrenal Fatigue 

1- The First Stage of Adrenal Fatigue: The Alarm Stage 

The first stage of adrenal fatigue is the alarm stage. This is the beginning stage that describes the body’s immediate reaction to a stressor. When we talk about stress we are talking about perceived stress: what stresses one person out may not stress out another. This stressor can be as simple as a job interview, a long to-do list, or as difficult as a hospital stay, death in the family etc.

During the first stage, your adrenals and body are capable of having an appropriate stress response. Cortisol, adrenaline, DHEA, and insulin all rise to help take care of you. You benefit from a state of increased arousal and alertness.

You may not notice that you are entering adrenal fatigue at this stage. You may become a bit more tired than usual, but you probably won’t consider a change. You may increase your intake of stimulants. 

2 – Stage Two: Resistance Response

Chronic stress leads to chronic hormone release resulting in inflammation, hormone imbalance, etc. During this stage, you will start to feel the effects of overexertion from your body’s stress system (HPA axis). Common symptoms of adrenal fatigue, like we mentioned, now come into play. And most likely, dependence on caffeine.

During this stage, your hypothalamus tells your pituitary gland to slow down cortisol production in order to protect your body. This is when chronic fatigue really sets in, and symptoms begin to rise.

At this point, you may go to a doctor, but your symptoms will be treated as a separate condition. For instance, you may experience depression, and you may be prescribed antidepressants. Maybe your fatigue will warrant thyroid medication. The problem is none of these will help you heal at the root. They are just bandaids. 

3 – Stage Three: Adrenal Exhaustion 

Stage three is when your adrenals are worked to the point of exhaustion, and your HPA axis downregulates to help protect your body. This means that you may experience pronounced insomnia, feel like you need a nap every afternoon, you are gaining weight for no reason, and cravings are out of control. 

At this point, you probably start to worry. 

You can’t seem to maintain energy, focus, or control over stress and anxiety. Everything becomes a chore, blood sugar levels are completely dysregulated, causing massive hormone imbalance and disruption to the body. 

Basically, what is happening is multiple endocrine axis dysfunction. Not just HPA but also HPA and HPT (ovarian and thyroid). A cascading decompensation happens, and we enter a disequilibrium state. Our body is severely compromised, and when left out of balance for too long, we reach stage four. 

4 – Stage 4: Complete Burnout and Adrenal Failure 

Stage four is the burnout phase when symptoms are at an all-time high, and it is very likely that you can reach adrenal insufficiency or Addison’s Disease. This is when the adrenals are no longer able to produce adequate hormones. Paying attention to your body before you reach the burnout stage is critical. 

While you can be in stage four adrenal fatigue without hitting insufficiency, it’s critical that you address it immediately because this is a very serious condition and can put you at high risk of cardiovascular collapse and even death. 

In this stage of adrenal fatigue, there is an increase in the severity of symptoms but it also brings new symptoms that can be sudden. This can be things like intense pain in the legs, lower back, and abdomen. Severe vomiting, dehydration, constipation, fainting, and a drop in blood pressure. 

This is why it’s so important to get help as soon as you start feeling off. 

Recovering from the Stages of Adrenal Fatigue 

Recovering from adrenal fatigue requires a complete lifestyle change. If you do what you’ve always done, you’re going to get what you always got. This starts with healing at the root. Changing your diet habits, your stress habits, maybe even your relationship and work situations. To learn more about adrenal fatigue and dive into recovery plans check out our Adrenal Fatigue Guide: Everything You Need to Know About AF & Healing. To shop our supplements specifically designed to nourish your adrenal glands, and hormones, and give you natural energy, go here.