Treating Sarah’s Chronic Fatigue and Hormonal Disruption

January 8, 2024by Dr. S. F. Czar0

Case Study:


Sarah, a 42-year-old marketing executive, had been battling unrelenting fatigue, weight gain, and mood swings for several years. Despite a healthy diet and regular exercise, her symptoms persisted, disrupting her career and personal life. After multiple doctor visits and inconclusive tests, Sarah sought functional medicine, hoping for a more holistic approach to her health struggles.

Initial Assessment:

Through comprehensive blood tests, saliva hormone testing, and detailed questionnaires, Sarah’s functional medicine practitioner, Dr. Lee, identified a complex hormonal imbalance. Key findings included:

  • Elevated cortisol and ACTH levels, indicative of chronic stress and HPA axis dysregulation.
  • Insulin resistance, suggesting impaired glucose metabolism.
  • Suboptimal thyroid function, potentially contributing to fatigue and weight gain.
  • Sex hormone imbalances with low progesterone and declining estrogen levels.
  • Sleep disturbances consistent with elevated noradrenaline levels.

Connecting the Dots:

Dr. Lee explained that Sarah’s symptoms pointed towards a cascading effect triggered by chronic noradrenaline overproduction. Stress-induced noradrenaline dysregulation was disrupting multiple hormonal systems, contributing to her fatigue, weight gain, and other complaints.

Personalized Treatment Plan:

Dr. Lee designed a multi-pronged treatment plan focused on restoring hormonal balance and addressing the underlying stress:

  • Stress Management: Mindfulness meditation, yoga, and cognitive-behavioral therapy (CBT) to reduce stress and stabilize the HPA axis.
  • Dietary Modifications: Switching to a low-glycemic, anti-inflammatory diet to improve insulin sensitivity, support gut health, and reduce inflammation.
  • Nutritional Supplementation: Targeted supplements like adaptogens for stress management, magnesium for cortisol regulation, and omega-3 fatty acids for inflammation reduction.
  • Sleep Hygiene: Implementing a consistent sleep schedule, creating a relaxing bedtime routine, and addressing sleep-disrupting factors.
  • Hormone Optimization: Bioidentical hormone replacement therapy to address sex hormone imbalances and optimize thyroid function.

Results and Impact:

Within three months of implementing the treatment plan, Sarah observed significant improvements:

  • Increased energy levels and reduced fatigue.
  • Improved sleep quality and wakefulness.
  • Weight loss and improved body composition.
  • Normalized menstrual cycles and reduced mood swings.
  • Enhanced sense of well-being and stress resilience.


Sarah’s case highlights the complex interplay between chronic stress, noradrenaline dysregulation, and hormonal imbalances. Through a holistic approach addressing the root cause and employing stress management, dietary modifications, targeted supplements, and personalized hormone optimization, Sarah regained her energy, health, and quality of life. This case study demonstrates the potential of functional medicine in unraveling hormonal mysteries and restoring patients to hormonal harmony.

Note: This case study is based on the fictional character Sarah and the information you provided on noradrenaline and its impact on different hormonal systems. The specific treatment plan is for illustrative purposes only and should not be interpreted as medical advice. Always consult with a qualified healthcare professional for personalized diagnosis and treatment recommendations.

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