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The adrenal glands sit on top of the kidneys and produce a variety of hormones, including adrenaline (epinephrine), cortisol and aldosterone.  These hormones play an important role in our sleep-wake cycle, stress response, energy availability, immune function, blood volume and electrolyte balance.  

Complete adrenal failure is known in traditional medicine as Addison's disease.
On the other side of the spectrum is Cushing's Syndrome - a collection of symptoms presenting after prolonged exposure to elevated levels of cortisol. Afternoon sleepiness is the hallmark of Adrenal Fatigue, a diagnosis frequently used by providers in the Integrative/Functional Medicine realm when cortisol levels are thought to be suboptimal at various times of the day. Insomnia, inability to manage stress and lightheadedness upon standing are also common symptoms which can also emerge. Analysis of a patient's symptoms, basic labs and expanded specialty lab panels are useful in choosing appropriate interventions. As always, we make a point of considering the underlying cause. This can be as simple as skipping breakfast but may involve chronic infectious agents or dysfunction elsewhere in the endocrine system. If Addison's disease is suspected, management of symptoms is in conjunction with an endocrinologist.