I'd post this on the existing adrenal fatigue thread, but that thread is long enough (eight pages already). Years ago, I was given a diagnosis of "adrenal fatigue." The following recount is my own personal experience with adrenal fatigue, and my opinion of the diagnosis in general. Years ago, I went to see an endocrinologist for various non-specific symptoms, including fatigue, anxiety, insomnia, and mood disturbances. Failing to find anything wrong with me except an impaired glucose tolerance test, he told me that my symptoms were due to prediabetes, and that I would feel much better if I adopted the Atkins diet. Being a well disciplined and compliant patient, I took to the diet wholeheartedly. Nothing but chicken breasts and leafy greens all day every day (I'd be surprised if I had over 20 g carbohydrates on any given day). I was already quite skinny at the time, but I lost a shit-load of weight anyway. To give you an idea: I wasn't working out at the time, but I would routinely register a 6% bodyfat reading on those (albeit inaccurate) bodyfat reading scales. I had noticed some other changes as well: elevated heart rate, increased moodiness and anxiety, tremors, etc. My blood pressure was routinely on the lowish side at 100/70. I would often "brown out" when I stood up. I felt like shit. I brought my complaints to my endocrinologist, and he tested my adrenal glands. My ACTH was highish, usually in the 40s (but sometimes in the 80s), and my cortisol was high as well. He told me that I had adrenal fatigue, and prescribed me .5 mg tablets of dexamethasone, to be taken once per day. I was suspicious. I knew that GCs were nothing to fuck around with, so I decided I would try a small dose first. I started on 1/4 of a .5 mg tablet. I didn't notice any change at all, so I decided to increase my dose to 1/2 a tablet. At this dosage, I couldn't be sure if I actually felt better, or if it was just the placebo effect. In any case, I decided that I'd just keep taking it, since it was such a small dosage, I figured that it couldn't really suppress my HPA axis. I noticed that my morning blood sugar readings were slowly creeping upwards. I went from the low to mid 80s up to the mid 90s all of a sudden. My skin was oily all the time, and I was getting some acne. My blood work was still coming back with highish cortisol, so my doctor insisted that I take the full dosage. I agreed, and went up to the full .5 mg tablet, once per day. Within a few weeks, my acne got pretty bad. And suddenly, my morning blood sugar was 105. I was on my way to becoming diabetic. I brought this concern up to my doctor, and he assured me that if and when I became diabetic, that there were good treatments available. That was enough for me. I got a 2nd and 3rd opinion, and both of them said "Get off the glucocorticoids!!" Needless to say, I didn't go back to the first doctor. I did some research, and found that keeping your body in a perpetual state of ketosis (a la the Atkins diet) often raises cortisol levels. I decided that I would treat my "prediabetes" with a low-glycemic diet (as opposed to low carb), and most importantly, I started exercising regularly. My fasting blood sugar came back down to normal, I gained a significant amount of muscle, and I was feeling better. My blood tests showed normal ACTH and normal cortisol levels. I don't expect to convince anyone that adrenal fatigue is a fictional diagnosis, nor do I expect to convince anyone that I didn't have adrenal fatigue; I understand that this issue has some pretty intense advocates with equally intense feelings fueling their opinions, and most people reading this thread will leave with the same opinion that they started with. However, I would like to point out the following: Glucocorticoids can and will fuck you up. They have dangerous side effects. This is why so many doctors don't support the diagnosis of adrenal fatigue: the treatment can be worse than the disease. Far too many people are getting diabetes. There are obviously serious health consequences from diabetes that I won't mention, but I will mention the often overlooked ones: ED, fatigue, and moodiness. Sound familiar? These are symptoms of adrenal fatigue. In other words, treating these symptoms with glucocorticoids can make them permanent! If you really believe you have something wrong with your HPA, then get it tested properly. This includes a dexamethasone suppresion test, an ACTH stimulation test, AM cortisol and ACTH blood tests, 24 hour urinary cortisol, etc. If there is anything wrong with your HPA, this will find it. In my opinion, I just had a form of chronic stress (lack of carbohydrate) that was keeping my cortisol elevated, and taking dexamethasone was just helping my body catabolize its own tissues! Sure, I felt better, but that was probably just due to the catabolic effect of the GCs (my brain was getting all the sugar it needed). Lastly, consider the dose that you will be taking. The dexamethasone suppression test is meant to completely suppress HPA activity. The dosage given for this suppression is 1 mg. That is equivalent to 26.67 mg of hydrocortisone, 6.67 mg of prednisone, or 5.33 mg of methylprednisolone. Do you really want to completely suppress your adrenal glands, even if only for part of the day? (See Corticosteroids conversion calculator (hydrocortisone, dexamethasone, prednisone, methylprednisolone, betamethasone for a calculator to determine steroid equivalence.) If you must use GCs for adrenal fatigue, use a very low dose, and have your ACTH tested while on this dose. If your ACTH is being suppressed, then you are taking too much. My opinion: glucocorticoids are a miracle drug for those who actually need them. For everyone else, they are just a great way to help your body destroy itself, even if you feel better in the short term.