Adrenal fatigue encompasses a broad range of symptoms that can precede adrenal exhaustion. In reality, most patients with adrenal fatigue never progress beyond stage 1 or 2, while many completely recover without ever receiving an accurate diagnosis.

Throughout this disease, hormone and neurotransmitter levels may fluctuate significantly. To correctly interpret laboratory tests for adrenal fatigue, one must first understand how the body’s systems interact during each of these stages. Only then can you determine your stage of adrenal fatigue and initiate treatment.

Each stage of adrenal fatigue has its own set of symptoms and stress hormone levels and is classified into four stages. Without further ado, we’ll dive right in to discuss the four stages of Adrenal Fatigue. Read on to discover everything you need to know!

Stage 1: The ‘Alarm’ Phase

Stage 1 refers to the body’s initial response to a stressor. During the initial phases of a stress reaction, the body may produce massive amounts of the hormones required for response. Lab testing will reveal increased levels of adrenaline, norepinephrine, cortisol, and insulin.

Stage 1 involves increased arousal and awareness. Your sleeping patterns, on the other hand, may deteriorate, and you may become fatigued. People rarely report their symptoms at this stage because it is a natural response to occasional stressful periods in your life.

Stage 2: The Prolonged ‘Alarm’ Phase

The second stage involves the body’s continuous response to stress. Although DHEA and other sex hormone levels may begin to decline, your endocrine system can continue to generate important hormones. Therefore, the resources necessary for sex hormone production are redirected to the synthesis of stress hormones such as cortisol.

During this stage, you will begin to feel the symptoms of adrenal exhaustion. Being “wired yet fatigued” is a state of being alert throughout the day and readily falling asleep at night. During this time frame, those who suffer from adrenal fatigue may develop caffeine dependence.

Stage 3: The ‘Resistance’ Phase

Your endocrine system prioritizes stress hormones above sex hormones during this period. When precursor material for hormones is redirected to the cortisol synthesis pathway, DHEA and testosterone levels fall. 

You can still function, work, and live a somewhat normal and productive life at this point. However, low levels of several critical hormones may have an effect on the quality of life. Common symptoms include fatigue, loss of excitement, and decreased sex drive. This period may last several months, if not years.

Stage 4: The ‘Burnout’ Phase

Through periods of prolonged stress, the body will eventually exhaust all mechanisms for producing stress hormones, and cortisol levels begin to decline. All types of hormones reach a record low along with neurotransmitter levels. 

This pervasive hormonal imbalance affects nearly every organ and system in the body. As a result, you may experience symptoms such as excessive fatigue, lack of sex drive, wrath, grief, and worry, as well as weight loss and apathy. Recovery from Stage Four adrenal fatigue requires a lot of time and focus, not to mention a change in your lifestyle.


No matter how much we take care of our bodies, physiological concerns may still develop in time. And as we age, we may encounter numerous health issues that we may not initially understand. Thus, we must seek professional advice about conditions we may experience, such as adrenal fatigue. 

Now that you are equipped with some knowledge on the stages of adrenal fatigue, you can understand the effects on your body and manage symptoms better.

Are you in need of adrenal fatigue treatment? Balanced Body Functional Medicine offers integrative medicine that could be personalized for your needs. With us, you get outstanding bio-identical hormone replacement to combat the severe effects of aging. Subscribe now to get $75 off your first visit!

Nathan Marchand

Author Nathan Marchand

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