Divermon

Do you find that you are generally less fatigued in the early morning and in the evening, but more fatigued during the day?

Note that M.D. usually do not recognize any adrenal issues other then full-blown Addisons (hypo) or Cushings (hyper) disease. However there is a condition known as Adrenal Exhaustion or Adrenal Insufficiency. This is when the output of cortisol from your adrenal glands is low enough to cause extreme fatigue.

The adrenal glands produce cortisol in a cyclical nature. The normal output for 6:00 AM, for example, is very different than that of 1:00 PM. Most M.D.s are not aware of this, or not aware of the significance. They will typically either do a blood test or a urine test.

The blood test is generally taken at an arbitrary time of the day, and ignores this cyclical factor. This test is worthless for diagnosing Adrenal Exhaustion.

The urine test, is generally taken by collecting urine over a 24-hour period, and then compared to a normal average. This test may seem to make more sense, as it would indicate the average over the day, and thus, include the cyclical factor. However this test, is also worthless in diagnosing Adrenal Exhaustion. This is because it is actually quite common for a patient with this condition to have normal or high-normal cortisol output in the early morning and in the evening, yet to have low cortisol output during the day. The 24-hour average, would not adequately highlight this.

The correct test for this condition is the saliva test, where you spit into a vial at four times in one day, and each vial is tested independently. This gives a good look at your cycle. My cycle, for example is:

6:00-8:00 AM mid-normal
12:00-1:00 PM Low
4:00-5:00 PM Low
10:00PM-12:00AM high-normal

You can probably guess that a person with this pattern, could feel pretty good in the early morning and late evening, but feel exhausted during the day.

Now, the test you had done just tests the Pituitary - Hypothalamus - Adrenal hormonal feedback/control loop. That is really somewhat unrelated to what I'm suggesting above.

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My opinions only, not medical advice. Always follow advice of your Doctor, not what I say here.